Top 742 Provider Relations Jobs

Provider Relations Specialist
Altus ACE —Houston, TX
- $70,000 - $85,000 a year
- Full-time
- Microsoft Outlook
- Mid-level
- Presentation skills
- Health savings account
- Health insurance
Quick Apply
10d
Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
Associate Representative, Health Plan Provider Relations - Remote must reside in UT
Molina Healthcare —Utah
- $18.04 - $35.17 an hour
- Full-time
- Remote
- Medical office experience
- Research
- Communication skills
- Health insurance
Provider Relations Representative (Remote in AZ - Pima or Pinal)
Imperial Management Administrators Services Inc —Arizona
- $30 - $32 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Marketing
Quick Apply
Service Support Analyst - Medicaid Provider Relations
Software Technology Inc —Remote
- HIPAA
- Mid-level
- Bachelor's degree
Quick Apply
Physician Relations Specialist (Remote)
M3USA —Creve Coeur, MO
- Full-time
- Remote
- High school diploma or GED
- Experience equivalent to degree accepted
- Communication skills
- Paid holidays
- Disability insurance
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Provider Relations Specialist- TX
The Emily Program —Dallas, TX
- $95,000 - $125,000 a year
- Weekends as needed
- Remote
- Marketing
- Mid-level
- High school diploma or GED
- Health savings account
- Paid holidays
Quick Apply
Provider Relations Representative I (Hybrid)
CareFirst BlueCross BlueShield —Baltimore, MD
- $49,464 - $98,241 a year
- Full-time
- Microsoft Word
- Microsoft Access
- Up to 50% travel
Quick Apply
Health Plan Provider Relations Manager (Remote in Iowa)
Molina Healthcare —Iowa
- $57,394.00 - $117,808.76 a year
- Full-time
- Remote
- 6 years
- Mid-level
- Presentation skills
- Health insurance
11d
Senior Developer Relations Manager – Cloud Provider AI Factory
NVIDIA —California
- $224,000 - $356,500 a year
- Full-time
- Computer science
- Computer Science
- 5 years
Provider Relations Program Manager (PPM II)
King County —Seattle, WA
- $97,777.26 - $123,938.05 a year
- Overtime
- Microsoft Word
- Microsoft Outlook
- Writing skills
Representative, Health Plan Provider Relations (( Wisconsin long-term services and supports (LTSS) Provider Quality; must reside in Wisconsin)
Molina Healthcare —Wisconsin Rapids, WI
- $19.84 - $38.69 an hour
- Full-time
- Medical office experience
- Mid-level
- Residential
- Health insurance
Representative, Hospital Health Plan Provider Relations (FL)
Molina Healthcare —Florida
- $19.84 - $38.69 an hour
- Medical office experience
- Mid-level
- Training & development
- Health insurance
Senior Provider Relations Advocate - Remote - Pacific Coast Hours
UnitedHealthcare —Seattle, WA
- $72,800 - $130,000 a year
- Full-time
- Hospital
- Customer service
- Pass drug screening
4d
Provider Relations Specialist- IL
The Emily Program —Chicago, IL
- $90,000 - $125,000 a year
- Weekends as needed
- Remote
- Marketing
- Mid-level
- High school diploma or GED
- Health savings account
- Paid holidays
Quick Apply
Senior Manager, Provider Relations Manager (Metro NY)
CVS Health —New York, NY
- $82,940 - $199,144 a year
- Full-time
- Office
- Bachelor's degree
- Travel
- Health insurance
- Dental insurance
Provider Relations Specialist- NY
The Emily Program —New York, NY
- $95,000 - $125,000 a year
- Weekends as needed
- Remote
- Marketing
- Mid-level
- High school diploma or GED
- Health savings account
- Paid holidays
Quick Apply
Physician Liaison
US Foot & Ankle Specialists —Toms River, NJ
- $65,000 - $85,000 a year
- Evenings as needed
- Surgery
- Marketing
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
Physician Liaison- Hybrid
Mindcolor Autism —Milwaukee, WI
- Weekends as needed
- Marketing
- Mid-level
- Bachelor's degree
- Paid parental leave
- Disability insurance
Quick Apply
Director - Pharmacy Network Contracting & Public Payer Relations
Hemophilia Alliance —Remote
- $130,000 - $170,000 a year
- Full-time
- Background check
- Up to 50% travel
- 5 years
- Health savings account
- Health insurance
Quick Apply

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Provider Relations Specialist

Altus ACE -
Houston, TX

Quick Apply

Job Details

Full-time
$70,000 - $85,000 a year
10 days ago

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Employee discount

Qualifications

Sales contract management
Microsoft Outlook
Presentations for conferences or internal meetings
Account development
Contract management experience in healthcare
Bachelor's degree
Health insurance knowledge
Quality improvement
Medical credentialing
Organizational skills
Contracts
Data-driven problem-solving
Business Administration

Full Job Description

Job Title:

Provider Network Specialist

Reports To:

SVP, Network Operations

FLSA Status:

Exempt

Department:

Network Operations & Contracting

Job Summary

The Provider Network Specialist is responsible for growing and servicing Altus ACE’s primary care provider network across Medicare, Medicare Advantage, Medicaid, and commercial value-based care contracts. This is a dual-role position requiring both business development (recruiting and closing new PCPs) and account management (servicing existing provider groups to ensure satisfaction, retention, and performance against contract SLAs).

The ideal candidate combines a working knowledge of managed care and value-based care with strong sales instincts, relationship management skills, and the ability to interpret performance data and communicate actionable insights to providers.

Essential Functions

1. Network Growth & PCP Recruitment

Prospect, recruit, and close new primary care physicians to join Altus ACE’s provider network and assigned PODs.
Build and maintain a pipeline of prospective PCPs with managed care experience who are positioned to capitalize on their attributed patient populations through value-based care arrangements.
Guide prospective providers through the full contracting process, from initial outreach to executed agreement.
Collaborate with senior leadership to identify strategic growth targets by geography, payor mix, and contract need.
Track recruitment activity and conversion metrics, reporting progress against growth targets.
Lead contract negotiations with physicians.
Assist with provider credentialing by ensuring all necessary documents are completed promptly and accurately.

2. Account Management & Provider Servicing

Serve as the primary point of contact for assigned provider groups, owning the ongoing relationship and ensuring provider satisfaction and retention.
Conduct regular site visits to provider locations, responding promptly to operational issues and proactively identifying needs.
Orient newly contracted providers to Altus ACE programs, systems, and processes, ensuring a smooth onboarding experience.
Provide training and support to providers and their staff on managed care topics, VBC program requirements, and ACE workflows.
Develop educational materials to support provider understanding and facilitate behavior change aligned with population health goals.
Act as a liaison between healthcare providers and the Altus ACE Network team, fostering strong professional relationships.

3. POD Operations & JOC Meeting Management

Own the end-to-end Joint Operating Committee (JOC) meeting process for assigned PODs: pull performance data, assemble the meeting packet, set and drive the agenda, facilitate the meeting, and follow up on action items.
Monitor POD performance metrics against payor contract SLAs, including shared savings, medical loss ratio, quality measures, and HCC recapture rates.
Present performance data to providers during JOC meetings and site visits, translating data into clear, actionable improvement opportunities.
Track PCP satisfaction within PODs and implement improvements as needed.

4. Clinical Operations & Population Health Support

Identify opportunities with local providers to support clinical and quality-related operations.
Contribute to the organization’s overall population health management strategy by reinforcing care gap closure and quality improvement at the practice level.
Respond to routine member and provider inquiries regarding managed care issues, providing accurate and helpful information.
Perform other related tasks as assigned, contributing to the success and efficiency of the Altus ACE network.

Qualifications

Required

Bachelor’s degree in healthcare administration, business, or related field, or equivalent combination of transferable work experience and education.
2+ years of experience in provider relations, network development, healthcare sales, or managed care operations.
Demonstrated understanding of managed care fundamentals: contracting, credentialing, provider networks, and payor relationships.
Working knowledge of value-based care concepts, including shared savings, risk arrangements, medical loss ratio, and quality/performance metrics.
Proven ability to close: track record of recruiting providers, closing contracts, or driving sales in a healthcare or professional services environment.
Excellent communication and presentation skills with both internal and external audiences, including the ability to present data-driven performance insights to physicians.
Strong relationship-building, problem-solving, and organizational skills.
High proficiency with MS Office (Word, Excel, PowerPoint, Outlook), with particular strength in Excel for data analysis and reporting.

Preferred

Experience working in an MSO, IPA, ACO, or similar value-based care organization.
Experience preparing and presenting dashboards using data visualization tools such as Tableau or Power BI.
Familiarity with Medicare, Medicare Advantage, and Medicaid programs and their associated quality measures (HEDIS, Stars, HCC coding).

Pay: $70,000.00 - $85,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Employee discount
Flexible spending account
Health insurance
Health savings account
Paid time off
Vision insurance

Education:

Bachelor's (Required)

Experience:

Provider Relations: 2 years (Required)
Preparing/Presenting dashboards w/Tableau or Power BI: 1 year (Preferred)

Ability to Commute:

Houston, TX 77042 (Required)

Work Location: In person

Quick Apply

Refine Your Search

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