Provider Relations Associate

Overview

The Provider Relations Associate plays a pivotal role in recruiting, contracting, onboarding, and supporting healthcare providers engaged in both commercial and government programs. This role is focused on nurturing positive relationships with providers while ensuring accuracy and compliance of contracts and provider data according to corporate standards and regulatory guidelines.

Key Responsibilities

• Identify and recruit physicians, specialists, hospitals, and ancillary providers to strengthen commercial and government networks.
• Foster and maintain strong rapport with healthcare providers and their office teams.
• Manage provider contracting lifecycle including new agreements, amendments, renewals, and terminations.
• Educate providers regarding contract provisions, reimbursement policies, and participation requirements.
• Assist with onboarding processes including credentialing, training, and enrollments.
• Act as the primary liaison for provider inquiries about claims, credentialing, authorizations, billing, and reimbursements.
• Investigate and resolve provider-related issues cooperatively with internal departments.
• Maintain accurate and up-to-date provider and contract records within organizational systems.
• Conduct outreach and education to providers on policy changes, operational updates, and compliance obligations.
• Monitor provider satisfaction levels and identify improvement opportunities for services.
• Prepare detailed reports outlining provider recruitment, contracting status, and network activities.
• Collaborate with internal teams such as Training, Claims, Credentialing, and Compliance to support provider network operations.
• Perform other duties and special projects as assigned by leadership.

Required Qualifications

• Associate's degree in healthcare administration, credentialing, compliance, or a related field is preferred.
• 2 to 3 years of experience in provider relations, contracting, or healthcare administration roles.
• Demonstrated expertise in recruiting and relationship management with healthcare providers.
• Strong familiarity with provider contracting procedures and network development.
• Excellent skills in negotiation, communication, and professional presentations.
• Proven customer service skills and the ability to resolve conflicts effectively.
• Ability to juggle multiple projects and meet deadlines efficiently.
• Analytical mindset with strong problem-solving capabilities.
• Proficient in Microsoft Office Suite, CRM platforms, provider databases, and contract management software.

Core Competencies

• Provider recruitment and contracting expertise
• Relationship management and customer service excellence
• Clear communication and organizational skills
• Problem-solving aptitude
• Compliance with regulatory standards