Provider Relations Specialist | Network Growth & Education

American Health Partners; Carmel (IN); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Paid holidays

TeleDoc 24/7 access

Disability insurance

EAP

Job summary

American Health Plans, a division of American Health Partners Inc., operates ISNPs for seniors in long-term care facilities. This role contracts providers, ensures credentialing, educates providers on plan functions, and maintains strong provider networks to ensure CMS adequacy across service areas.

The position requires healthcare experience, strong negotiation and communication skills, and willingness to travel to network locations. Teleworking is optional if criteria are met.

Qualifications

• Must have knowledge of medical services and ability to build working relationships.
• Able to take instructions and work independently to meet goals.
• Strong negotiation, organization, presentation and time management skills.
• Excellent communication with medical staff to explain plans and benefits.

Responsibilities

• Contract providers and essential vendors in current service areas to maintain CMS adequacy.
• Ensure credentialing requirements are met for service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS updates and plan policies as prescribed.
• Conduct education presentations to ensure provider understanding and commitment.
• Maintain and support provider relationships to ensure network coverage.

Skills

Provider contracting

Credentialing

Provider education

Negotiation

Organization

Communication

Teamwork

Microsoft Office

Education

Bachelor's degree

Tools

Microsoft Office Suite

Job description

American Health Plans, a division of American Health Partners Inc., operates ISNPs for seniors in long-term care facilities. This role contracts providers, ensures credentialing, educates providers on plan functions, and maintains strong provider networks to ensure CMS adequacy across service areas.

The position requires healthcare experience, strong negotiation and communication skills, and willingness to travel to network locations. Teleworking is optional if criteria are met.