Provider Relations & Network Partnerships (Remote)

American Health Communities; Kansas City (KS); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time-off

TeleDoc access

Disability plans

EAP

401K retirement accounts

Referral bonus

Job summary

American Health Plans, a division of American Health Partners Inc., seeks a Provider Relations Specialist to support network development and CMS compliance. You will contract providers, ensure credentialing standards, and educate providers on plan features and care guidelines.

The role requires strong negotiation, organization, and communication skills, with the ability to work independently and as part of a team.

Qualifications

• Experience in the health care field is required.
• Strong negotiation, organization, presentation and time management skills.
• Ability to communicate with all levels of medical staff about plan programs and goals.
• Ability to work independently and in a team environment.

Responsibilities

• Contract providers and vendors in current service areas to maintain CMS adequacy.
• Ensure credentialing requirements are met for providers and service lines.
• Educate providers on Health Plan functions and roles.
• Conduct CMS-prescribed educational updates and provider presentations.
• Maintain provider relationships to ensure network coverage and participate in implementation as needed.
• Help create a positive work environment and contribute to process improvement.

Skills

Negotiation

Organization

Presentation

Time management

Communication with medical staff

Team collaboration

Microsoft Office Suite

Education

Bachelor’s degree

Tools

Microsoft Office Suite

Job description

American Health Plans, a division of American Health Partners Inc., seeks a Provider Relations Specialist to support network development and CMS compliance. You will contract providers, ensure credentialing standards, and educate providers on plan features and care guidelines.

The role requires strong negotiation, organization, and communication skills, with the ability to work independently and as part of a team.