Provider Relations Representative

Champion Health Plan; Las Vegas (NV); On-site; USD 60,000 - 75,000; Full time

Job summary

Champion Health Plan in Las Vegas, NV is seeking a Provider Relations Representative to foster strong relationships with network providers on-site. The role serves as the primary contact for questions, issues, and contract-related matters, supporting credentialing and policy education.

You will deliver training to providers and staff, coordinate with internal teams to resolve concerns, and ensure alignment with regulatory standards while maintaining high levels of provider satisfaction.

Qualifications

• Experience in provider relations and building professional relationships.
• Knowledge of network development and provider onboarding.
• Familiarity with credentialing processes and compliance in health plans.
• Proven customer service abilities with focus on issue resolution.
• Experience delivering training to providers and staff.
• Strong verbal and written communication.
• Attention to detail and ability to manage multiple tasks.
• Proficiency with standard office software; Medicare Advantage knowledge a plus.
• Ability to work with cross-functional teams.

Responsibilities

• Build and maintain positive relationships with network providers.
• Support network development initiatives and credentialing processes.
• Educate providers on plan policies and workflows.
• Resolve provider inquiries promptly and professionally.
• Collaborate with internal teams to address provider concerns.

Skills

Provider relations

Network development

Credentialing

Customer service

Training delivery

Communication

Detail-oriented

Multitasking

Team collaboration

Healthcare admin knowledge

Education

Associate's or Bachelor's in Healthcare Administration

Equivalent experience

Tools

Provider management systems

Credentialing software

Job description

Company Description

Champion Health Plan is dedicated to delivering Medicare Advantage Prescription Drug Plans that go beyond basic coverage to truly support Medicare beneficiaries. Through our Championed Care approach, we focus on listening, supporting, and empowering members to navigate their health with confidence and live life on their terms. Working with a strong network of exceptional providers, we offer high-quality, lower-cost care to individuals enrolled in Medicare Parts A & B in California and Nevada. Our plans are designed to meet members' diverse needs, whether they are managing chronic conditions, addressing behavioral health concerns, or seeking better value and guidance. Champion Health Plan is committed to championing Medicare beneficiaries at every stage of their health journey.

Role Description

The Provider Relations Representative is a full-time, on-site role based in Las Vegas, Nevada. This position is responsible for building and maintaining positive relationships with network providers, serving as a primary point of contact for questions, issues, and contract-related matters. Day-to-day activities include supporting network development initiatives, coordinating credentialing processes, and ensuring providers understand plan policies, procedures, and operational workflows. The role involves delivering training and education to providers and their staff, addressing service inquiries in a timely and professional manner, and collaborating with internal teams to resolve provider concerns. The Provider Relations Representative helps ensure provider satisfaction, accurate information, and alignment with regulatory and organizational standards.

Qualifications

• Demonstrated experience in provider relations and strong skills in building and maintaining professional relationships.
• Knowledge of network development practices, including supporting provider onboarding and network expansion.
• Familiarity with credentialing processes and compliance requirements within health plans or healthcare organizations.
• Proven customer service abilities, with a focus on responsive communication and issue resolution for providers.
• Experience delivering training or educational sessions to providers and office staff, in person and virtually.
• Strong verbal and written communication skills, with the ability to present information clearly and professionally.
• Attention to detail, organizational skills, and the ability to manage multiple tasks and priorities in a fast-paced environment.
• Proficiency with standard office software and provider management systems; experience in Medicare Advantage is a plus.
• Ability to work collaboratively with cross-functional teams and demonstrate sound judgment and problem-solving skills.
• Associate’s or Bachelor’s degree in a relevant field (such as Healthcare Administration, Business, or a related discipline), or equivalent experience in provider relations or managed care.