Provider Relations Specialist

Alignment Health; United States; On-site; USD 58,000 - 88,000; Full time

Job summary

Alignment Health is seeking a Provider Relations Specialist to manage relationships with healthcare providers. This role involves coordinating provider inquiries, evaluating performance, and supporting provider onboarding. Suitable candidates should have a background in provider relations and possess strong communication skills.

Qualifications

• Minimum 2 years of experience in provider relations / contracting with an HMO or IPA.
• Ability to establish and maintain relationships with diverse members and management.

Responsibilities

• Serves as the primary point of contact for provider inquiries and concerns.
• Coordinates with internal teams for resolution of provider issues.
• Assists in evaluating provider performance and satisfaction.

Skills

Effective written and oral communication skills

Mathematical Skills

Problem-Solving Skills

Report Analysis Skills

Education

High School Diploma or GED

Bachelor's degree or four years additional experience in lieu of education

MBA

Job description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Provider Relations Specialist will play a key role in supporting the Provider Relations Manager in maintaining positive relationships with healthcare providers and ensuring the smooth operation of provider-related activities within Alignment Health Plan with our Contracted Network (PCP, Specialists, Ancillary/Facility).

Job Duties/Responsibilities

• Serves as the primary point of contact for provider inquiries, requests, and concerns, and provide timely and professional assistance.
• Coordinates with internal teams in a timely manner for resolution of provider issues
• Assists in the evaluation of provider performance and satisfaction through surveys, feedback mechanisms, and data analysis
• Supports the Provider Relations Manager in maintaining and updating provider information impacting directories, networks, and contracts
• Works assigned tasks, including provider onboarding, call center queues, CRM, portal access requests, timely and accurately
• Attends and participates in all staff meetings as required
• Other duties as assigned
  
  

Experience

Job Requirements:

• Required: Minimum 2 years of experience in provider relations / contracting with an HMO or IPA, medical group or institutional provider required.
• Preferred: 5 years in field.
  
  

Education

• Required: High School Diploma or GED. Bachelor's degree or four years additional experience in lieu of education.
• Preferred: MBA
  
  

Specialized Skills

• Required:
• Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
• Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
• Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Report Analysis Skills: Comprehend and analyze statistical reports.
  
  

Licensure

• Required: None
  
  

Essential Physical Functions

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
  
  

Pay Range: $58,531.00 - $87,797.00

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

• DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [e-mail].

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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