See all roles

Provider Relations Manager- REMOTE

Work from home Full-time role Hiring

About the position The Provider Relations Manager is responsible for managing relationships with key health plans and provider networks to implement cost-saving products on a national scale. This role focuses on improving partnerships with health plan partners, resolving issues, and enhancing processes to ensure the success of the Provider Network. The manager will also conduct research on provider complaints, maintain communication with providers, and collaborate with various teams to ensure compliance and satisfaction. Responsibilities • Manage relationships with key health plans and provider networks. , • Resolve outstanding issues with health plan partners. , • Increase product utilization for each health plan partner. , • Enhance processes to serve the Provider Network effectively. , • Research provider complaints and collaborate with internal teams to find root causes. , • Establish and maintain strong communications with providers. , • Develop strategic approaches to engage high-impact providers. , • Maintain communication channels with client provider relations and account management. , • Identify opportunities for promoting web services to providers. , • Assist with network strategy committee meetings and application processing committees. , • Collaborate with credentialing teams to ensure provider compliance. , • Conduct training sessions for staff on contract and network management. Requirements • 5-8 years of experience in a Provider Relations role for a managed care plan. , • Bachelor's degree in a related field or at least 4 additional years of experience in healthcare, network development, or management. , • Solid knowledge of health plan operations required. , • Knowledge or experience in management of medical drug benefits, specialty pharmacy, pharmacy benefits management (PBM), behavioral health, or radiology may be required. Nice-to-haves • Master's degree preferred. Benefits • Competitive salary range of $60,800.00 - $97,280.00 based on experience and skills. , • Diverse and inclusive work environment. , • Opportunities for career advancement. , • Employee involvement and empowerment in decision-making. , • Recognition and rewards for achievements. Apply Job!

You might like

Associate, Renewal Portfolio Administrator

Work from home Full-time role

Real Estate Transaction Coordinator

Work from home Full-time role

Mid Level Insurance Specialist

Work from home Full-time role

Remote Medical Accounts Receivable

Work from home Full-time role

AS400 Developer (Part-time Job)

Work from home Full-time role

Provider Communication Writer Sr.

Work from home Full-time role

Remote Data Typist (Entry-Level)

Work from home Full-time role

Project Coordinator - Hourly

Work from home Full-time role

Remote Processor/Loan Officer Assistant

Work from home Full-time role

Charge Entry Specialist WFH

Work from home Full-time role

Cashier

Work from home Full-time role

Remote jobs at aetna - Supporting staff

Work from home Full-time role

Quality Assurance Manager, IT (Remote)

Work from home Full-time role

Hiring Now: Immediately Require Home Health Aide (HHA)

Work from home Full-time role

Experienced Part-Time Data Entry Specialist – Remote Talent Acquisition Support

Work from home Full-time role

Senior Quality Engineering Delivery Manager (Pharmaceutical Vertical) – Remote

Work from home Full-time role

Experienced Personal Lines Customer Service Representative – Remote Insurance Position at arenaflex

Work from home Full-time role

Experienced Remote Data Entry Specialist – Logistics and Delivery Operations

Work from home Full-time role

Remote Customer Service Representative – arenaflex Independent Contractor (Flexible Hours, Fortune 500 Support)

Work from home Full-time role

Director of Market Insights Content

Work from home Full-time role