Remote Provider Relations & Network Liaison

American Health Partners; St. Louis (MO); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Medical/Dental/Vision insurance

Paid time off & holidays for full time

TeleDoc 24/7/365 access to doctors

Disability plans (short & long-term)

Employee Assistance Plan (EAP)

401K retirement accounts

Employee Referral Bonus Program

Job summary

American Health Plans, a division of American Health Partners Inc., seeks a skilled professional to contract providers and vendors, maintain CMS adequacy, and educate providers about Health Plan functions. You will manage relationships, ensure credentialing, and support network coverage across service areas.

Travel to network provider locations is required; teleworking is possible if criteria are met. A Bachelor’s degree is required, with strong negotiation and MS Office skills to succeed in

Qualifications

• Experience in health care is required.
• Network development / network services experience preferred.
• Experience with Medicare Advantage plans is helpful.
• Experience with acute and post-acute facilities is beneficial.

Responsibilities

• Contracting providers and essential vendors to maintain CMS adequacy and provide services to Plan members.
• Ensure providers meet credentialing requirements for their service lines.
• Educate providers on Health Plan functions and roles.
• Provide ongoing CMS-prescribed educational updates for Health Plans.
• Educate Health Plan providers to ensure understanding and commitment.
• Maintain provider relationships to ensure network coverage in all areas.
• Collaborate on implementation and contribute to process improvements.
• Foster a positive work environment and drive department and company success.
• Complete corporate assignments as needed.

Skills

Medical services knowledge

Independent worker

Negotiation & time management

Communication with medical staff

Team player

MS Office

Self-motivation

Education

Bachelor's degree

Tools

MS Office Suite

Job description

American Health Plans, a division of American Health Partners Inc., seeks a skilled professional to contract providers and vendors, maintain CMS adequacy, and educate providers about Health Plan functions. You will manage relationships, ensure credentialing, and support network coverage across service areas.

Travel to network provider locations is required; teleworking is possible if criteria are met. A Bachelor’s degree is required, with strong negotiation and MS Office skills to succeed in