Provider Relations & Network Development Specialist

American Health Plans; Odessa, Northern (TX, KY); Híbrido; USD 75 000 - 95 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical/Dental/Vision insurance

Generous paid time-off

TeleDoc 24/7/365 access to doctors

Disability plans (short/long-term)

Employee Assistance Plan (EAP)

401K retirement accounts

Employee Referral Bonus Program

Resumo da oferta

American Health Plans, a division of American Health Partners Inc., seeks a Provider Relations professional to contract providers and manage credentialing for CMS adequacy. The role includes educating providers, maintaining network coverage, and collaborating on implementation projects across service areas, with travel to provider locations as needed.

Ideal candidates have healthcare experience and strong negotiation, communication, and team skills.

Qualificações

• Bachelor's degree required.
• Healthcare field experience required.
• Network development/maintenance experience preferred.
• Familiarity with CMS credentialing processes recommended.
• Strong negotiation, organization, presentation and time management skills.

Responsabilidades

• Contract providers and essential vendors in current service areas to maintain CMS adequacy.
• Ensure providers meet credentialing requirements for service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS-driven educational updates.
• Deliver education presentations to ensure provider understanding and commitment.
• Monitor and support provider relationships to maintain network coverage.
• Collaborate in implementation projects as needed.
• Foster a positive environment and participate in process improvements.

Conhecimentos

Provider payment methods

Medical services knowledge

Independent work

Negotiation

Communication with medical staff

Team collaboration

Self-motivation

Formação académica

Bachelor's degree

Descrição da oferta de emprego

American Health Plans, a division of American Health Partners Inc., seeks a Provider Relations professional to contract providers and manage credentialing for CMS adequacy. The role includes educating providers, maintaining network coverage, and collaborating on implementation projects across service areas, with travel to provider locations as needed.

Ideal candidates have healthcare experience and strong negotiation, communication, and team skills.