Provider Relations Specialist: Educate, Resolve & Engage

CareFirst BlueCross BlueShield; Baltimore (MD); On-site; USD 49,000 - 98,000; Full time

Job summary

CareFirst BlueCross BlueShield in Baltimore, MD is seeking a Provider Relations Specialist to serve as the primary liaison for in-network providers across Health Services and the company. The role emphasizes building strong provider relationships, delivering ongoing education, and resolving issues to support member care and corporate goals.

Key duties include relationship management, training, issue resolution, and project management to improve provider experiences and performance metrics.

Qualifications

• Education level as stated: Associate's degree or equivalent; 2 years of related experience if no Associate's degree.
• 2 years experience with CareFirst computer systems, networks, products, policies and provider processes.

Responsibilities

• RELATIONSHIP MANAGEMENT: Establishes and maintains provider relationships and drives favorable outcomes.
• TRAINING AND EDUCATION: Provides ongoing training to providers on portal use and processes.
• ISSUE RESOLUTION: Researches and resolves escalated service issues with internal partners.
• PROJECT MANAGEMENT: Supports network projects to mitigate risk and support initiatives.

Skills

Relationship management

Training and education

Issue resolution

Project management

Microsoft Office

Education

Associate's degree or equivalent experience

Bachelor's degree in business, healthcare administration or related

Tools

Microsoft Excel

Microsoft Access

Microsoft PowerPoint

Microsoft Word

Job description

CareFirst BlueCross BlueShield in Baltimore, MD is seeking a Provider Relations Specialist to serve as the primary liaison for in-network providers across Health Services and the company. The role emphasizes building strong provider relationships, delivering ongoing education, and resolving issues to support member care and corporate goals.

Key duties include relationship management, training, issue resolution, and project management to improve provider experiences and performance metrics.