Provider Relations & Network Development Specialist

TruHealth; Oregon; Hybride; USD 60 000 - 90 000; Plein temps

Avantages offerts par ce poste

Health insurance

Paid time off

TeleDoc access

Disability plans

EAP

401K retirement accounts

Referral bonus

Résumé du poste

American Health Plans, a division of American Health Partners Inc., seeks a skilled network development professional in Oregon to contract providers and key vendors and ensure CMS credentialing standards for Medicare Advantage networks.

The role requires strong negotiation, relationship management, and the ability to educate providers on plan functions. Travel to network locations is required; teleworking is possible for qualifying candidates.

Qualifications

• Experience in the health care field.
• Familiarity with provider contracting and CMS requirements.
• Ability to travel to network provider locations.
• Strong negotiation and communication skills.
• Proficiency with Microsoft Office.

Responsabilités

• Contract providers and essential vendors in current service areas to maintain CMS adequacy and provide necessary services.
• Ensure providers meet credentialing requirements for their service lines.
• Educate providers on Health Plan functions and roles.
• Conduct CMS-prescribed educational updates.
• Present health plan information to providers to ensure buy-in.
• Monitor and support provider relationships to maintain network coverage.
• Collaborate on implementation and process improvements.
• Foster a positive work environment and contribute to department success.
• Complete corporate assignments as needed.

Connaissances

Provider payments

CMS credentialing

Negotiation

Relationship management

Education presentations

Team collaboration

Microsoft Office

Formation

Bachelor's degree

Description du poste

American Health Plans, a division of American Health Partners Inc., seeks a skilled network development professional in Oregon to contract providers and key vendors and ensure CMS credentialing standards for Medicare Advantage networks.

The role requires strong negotiation, relationship management, and the ability to educate providers on plan functions. Travel to network locations is required; teleworking is possible for qualifying candidates.