Provider Relations & Network Development Specialist

American Health Plans; St. Louis (MO); Hybrid; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical/Dental/Vision insurance

Paid time off & holidays

TeleDoc 24/7 access

Disability plans (short & long-term)

Employee Assistance Plan (EAP)

401K retirement accounts

Referral bonus program

Job summary

American Health Plans is seeking a detail‑oriented professional to manage provider contracting and network relations. The role supports CMS adequacy, credentialing, and coordinated care for seniors in long‑term facilities.

The ideal candidate has healthcare experience, strong negotiation skills, and the ability to work independently while collaborating with a multidisciplinary team. Teleworking may be possible with criteria met.

Qualifications

• Experience in the health care field required.
• Prior experience with network development or vendor contracting is beneficial.
• Ability to communicate with diverse medical staff and negotiate effectively.

Responsibilities

• Contract providers and vendors to maintain CMS adequacy.
• Ensure credentialing requirements are met for service lines.
• Educate providers on Health Plan functions and CMS policies.
• Maintain provider relationships to ensure network coverage.
• Travel to network provider locations as needed.

Skills

Healthcare experience

Negotiation

Communication

Team player

Independent work

Education

Bachelor's degree

Job description

American Health Plans is seeking a detail‑oriented professional to manage provider contracting and network relations. The role supports CMS adequacy, credentialing, and coordinated care for seniors in long‑term facilities.

The ideal candidate has healthcare experience, strong negotiation skills, and the ability to work independently while collaborating with a multidisciplinary team. Teleworking may be possible with criteria met.