Provider Relations & Network Development Specialist

American Health Partners; Westfield (IN); Hybrid; USD 65,000 - 85,000; Full time

Job summary

American Health Plans, a division of American Health Partners Inc., seeks a qualified professional to contract providers and vendors, maintain CMS adequacy, and educate providers about plan functions. The role requires travel to network locations and collaboration with internal teams to ensure optimal network coverage.

The ideal candidate has healthcare experience, strong negotiation skills, and the ability to work independently within a team, with a focus on meeting CMS guidelines and improving

Qualifications

• Experience in health care is required.
• Bachelor's degree is required.
• Ability to travel to network provider locations.

Responsibilities

• Contract providers and essential vendors to maintain CMS adequacy.
• Ensure credentialing requirements are met for service lines.
• Educate providers on plan functions and roles in care.
• Monitor provider relationships to ensure network coverage.
• Work with implementation as needed.
• Complete corporate assignments as assigned.

Skills

Medical knowledge

Independence

Negotiation

Organizational Skills

Communication

Teamwork

Microsoft Office

Self-motivation

Education

Bachelor's degree

Tools

MS Office

Job description

American Health Plans, a division of American Health Partners Inc., seeks a qualified professional to contract providers and vendors, maintain CMS adequacy, and educate providers about plan functions. The role requires travel to network locations and collaboration with internal teams to ensure optimal network coverage.

The ideal candidate has healthcare experience, strong negotiation skills, and the ability to work independently within a team, with a focus on meeting CMS guidelines and improving