Remote-Eligible Provider Relations Specialist

American Health Partners; Kansas City (MO); A distancia; USD 70.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Paid time off

TeleDoc access

Disability plans

EAP

401K retirement accounts

Referral bonus

Descripción de la vacante

American Health Plans is seeking a Provider Network Development professional to manage contracting, credentialing, and education for Plan members. You will develop relationships with providers and ensure CMS adequacy across service areas while supporting implementation and ongoing policy updates.

Travel is required to network locations; teleworking is an option if criteria are met. This full-time role offers a dynamic environment focused on network growth and quality care delivery.

Formación

• Bachelor’s degree required or equivalent experience.
• Experience contracting providers and maintaining networks.
• Knowledge of credentialing requirements and CMS processes.
• Strong communication and presentation skills for provider education.
• Ability to work independently and as part of a team.
• Experience in health care or Medicare Advantage is preferred.

Responsabilidades

• Contract providers and vendors to maintain CMS adequacy and services.
• Ensure credentialing requirements are met for service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS updates as prescribed by policies.
• Present education to Health Plan providers to ensure understanding.
• Monitor provider relationships to maintain network coverage.
• Collaborate on implementation projects as needed.
• Promote a positive environment and support process improvement.
• Complete corporate assignments as assigned.

Conocimientos

Provider contracting

Credentialing knowledge

Relationship building

Negotiation skills

Communication skills

Teamwork

MS Office

Educación

Bachelor’s degree

Herramientas

Microsoft Office

Descripción del empleo

American Health Plans is seeking a Provider Network Development professional to manage contracting, credentialing, and education for Plan members. You will develop relationships with providers and ensure CMS adequacy across service areas while supporting implementation and ongoing policy updates.

Travel is required to network locations; teleworking is an option if criteria are met. This full-time role offers a dynamic environment focused on network growth and quality care delivery.