Provider Relations & Network Development Specialist

American Health Plans; San Antonio (TX); Híbrido; USD 65.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical/Dental/Vision insurance

Paid time off

TeleDoc access

Disability plans

EAP

401K

Referral bonus

Descripción de la vacante

American Health Plans in San Antonio, TX, is seeking professionals to contract providers and vendors, ensuring CMS adequacy and proper credentialing. The role includes educating providers about plan functions and maintaining strong provider relationships.

The position requires coordinating with health plan policies, staying current with CMS updates, and supporting a team focused on delivering high-quality care to plan members. Teleworking is optional where criteria are met.

Formación

• Knowledge of provider payment methodologies (per diems, DRGs, APCs).
• Ability to build working relationships with medical staff and providers.
• Ability to work independently and meet goals and assignments.
• Strong negotiation, organization, presentation, and time management skills.

Responsabilidades

• Contract providers and essential vendors to maintain CMS adequacy.
• Ensure credentialing requirements are met for service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS and Health Plan policy updates.

Conocimientos

Provider payments

Negotiation

Communication

Teamwork

Time management

Educación

Bachelor's degree

Descripción del empleo

American Health Plans in San Antonio, TX, is seeking professionals to contract providers and vendors, ensuring CMS adequacy and proper credentialing. The role includes educating providers about plan functions and maintaining strong provider relationships.

The position requires coordinating with health plan policies, staying current with CMS updates, and supporting a team focused on delivering high-quality care to plan members. Teleworking is optional where criteria are met.