Remote Provider Relations Specialist

CenterWell Certified Healthcare Corp.; United States; Remote; USD 59,000 - 81,000; Full time

Job summary

CenterWell Certified Healthcare Corp. is seeking a Provider Relations Representative to manage day-to-day relationships with network providers in Illinois, focusing on onboarding, training and timely issue resolution.

You will build long-term partnerships and ensure positive provider experiences across Humana’s Dual Fully Integrated and Healthy Horizon plans. The role requires 2+ years in health care or managed care, residence in Cook County, IL, and frequent travel to provider sites.

Qualifications

• Residence in Cook County, Illinois required.
• 2+ years healthcare/managed care provider experience
• Experience with Illinois Medicaid
• Experience with behavioral health providers
• Experience in provider operations and contracts
• Strong relationship management and interpersonal skills
• Understanding of managed care contracts
• Field-based role in Illinois with frequent travel

Responsibilities

• Meet with providers for training and education sessions
• Support onboarding with orientation sessions
• Respond to inquiries and resolve issues
• Collaborate with internal teams to ensure provider experience
• Develop provider trainings from feedback
• Educate providers on materials like Orientation, Provider Manual
• Organize regular provider meetings
• Educate on claims, authorizations, referrals, and related processes
• Communicate policy updates
• Coordinate provider townhalls and trainings
• Attend network meetings/conferences
• Ensure compliance with Virginia managed care contractual requirements for provider relations

Skills

Relationship management

Interpersonal skills

Provider onboarding/training

Health plan operations

Travel willingness

Tools

Availity

Job description

CenterWell Certified Healthcare Corp. is seeking a Provider Relations Representative to manage day-to-day relationships with network providers in Illinois, focusing on onboarding, training and timely issue resolution.

You will build long-term partnerships and ensure positive provider experiences across Humana’s Dual Fully Integrated and Healthy Horizon plans. The role requires 2+ years in health care or managed care, residence in Cook County, IL, and frequent travel to provider sites.