Strategic Provider Relations & Contracting Specialist

FrontPath Health Coalition; Ohio; On-site; USD 70,000 - 100,000; Full time

Job summary

FrontPath Health Coalition in Ohio is seeking a Provider Relations and Contracting Specialist to secure a robust provider network and deliver cost-effective access for members. You will manage contracting with facilities, ancillary and professional providers, and coordinate recredentialing and rate terms.

You will collaborate with underwriting, claims, and provider relations teams, analyze market data to inform negotiations, and communicate clearly with providers, brokers, and TPAs.

Qualifications

• Bachelor’s degree or equivalent work experience.
• 3+ years in provider contracting or claims oversight.
• Knowledge of local provider and purchaser markets.
• Proven ability to build strategic relationships with providers.
• Strong analytical skills to inform rate negotiations.
• Excellent written and verbal communication; team player.

Responsibilities

• Lead provider contracting with new and current participating providers.
• Oversee recredentialing cycles and review CAQH reports.
• Maintain provider database and weekly/monthly reporting.
• Coordinate issue resolution with FrontPath leaders.
• Manage implementation for new providers and rate agreements.
• Respond to provider inquiries on claims repricing and fee schedules.
• Oversee ClaimShop access and reverification with groups.
• Negotiate Single Case or large-case agreements as needed.
• Collaborate with stakeholders to strengthen provider relations.
• Perform other duties as assigned.

Skills

Provider contracting

Relationship building

Analytical skills

Communication skills

Teamwork

Education

Bachelor's degree

Tools

Word

Excel

Access

PowerPoint

Outlook

Job description

FrontPath Health Coalition in Ohio is seeking a Provider Relations and Contracting Specialist to secure a robust provider network and deliver cost-effective access for members. You will manage contracting with facilities, ancillary and professional providers, and coordinate recredentialing and rate terms.

You will collaborate with underwriting, claims, and provider relations teams, analyze market data to inform negotiations, and communicate clearly with providers, brokers, and TPAs.