Provider Relations Representative

Enterprise HCM; Albuquerque (NM); Hybrid; USD 56,000 - 124,000; Full time

Job summary

HCSC is seeking a provider relations liaison to enhance relationships with facility and physician providers. The role includes education, training, claims assistance, issue resolution, and ongoing provider service to improve satisfaction and understanding of policies and reimbursement processes.

The position requires travel within assigned areas, strong communication skills, and experience in managed care or healthcare administration. This is a hybrid role with in-office and remote work options.

Qualifications

• Bachelor’s degree and at least 3 years of work experience in managed care or 5 years in a managed care environment.
• Minimum of 2 years of health care administration experience with direct provider communication.
• Strong interpersonal, analytical, presentation, and communication skills.

Responsibilities

• Enhance relationships with facility and physician providers and serve as a liaison through education, training, claims assistance, issue resolution, and ongoing provider service.
• Support provider understanding of policies, procedures, and reimbursement processes while fostering positive relationships and satisfaction.

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for enhancing relationships with facility and physician providers and serving as a liaison through education, training, claims assistance, issue resolution, and ongoing provider service. The role supports provider understanding of policies, procedures, and reimbursement processes while fostering positive provider relationships and satisfaction.

Required Job Qualifications:

• Bachelor’s degreeand3years of work experience in managed care, or aminimum of5years’work experience in a managed care environment.
• Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
• Effective interpersonal, analytical,presentationand communication skills.
• Knowledge of the health care industry.
• Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
• Knowledge of contracts, applications, and products.
• Understanding ofprovider reimbursement methods.
• Working knowledge of claims processing systems.
• Effective organizational and planning skills.
• Analytical skills.
• Ability to take initiative and work independently.
• Demonstrated ability to meet deadlines and work well under pressure.
• Clear and concise interpersonal,verbaland written communication skills.
• Collaborationskills resulting in business/process improvements/changes.
• PC experience and skillsto includeWord, Excel, PowerPoint, etc.
• Facilitation,presentationand analytical skills.

Preferred Qualifications:

• Experience supporting provider relationships within a managed care, health plan, hospital, or physician practice environment.
• Knowledge of provider office workflows, practice operations, and healthcare administrative processes.
• Strong customer service mindset with a focus on provider satisfaction and relationship management.
• Ability to identify trends and recurring provider concerns to support operational improvements.
• Demonstrated ability to prioritize multiple assignments while maintaining accuracy and attention to detail.

This is a Flex position that requires 3 days in office and 2 days work from home.

Compensation: $55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards