Provider Relations Specialist

This is a fully remote position, open to applicants in Florida, +1 more state.

📋 Description

• Act as the primary day-to-day contact for providers concerning inquiries, documentation, and follow-ups on ongoing negotiations.

• Foster essential provider relationships through monthly reviews, quarterly business reviews (QBRs), and annual stewardship meetings with select providers.

• Assist in managing significant vendor and partner relationships, which includes conducting monthly reviews, QBRs, and annual stewardships.

• Aid in the execution and monitoring of single case agreements, letters of agreement, and other provider arrangements.

• Ensure the maintenance of precise contract records and provider contact logs.

• Support the preparation of necessary documentation and materials for discussions with providers.

• Help coordinate the onboarding and education of providers regarding Paradigm programs and expectations.

• Monitor vendor deliverables and escalate any issues to the Director.

• Assist with data tracking and reporting related to the performance of vendors and partners.

• Compile and analyze data that supports provider engagement, payment strategy, and network optimization efforts.

• Create summary reports or visual representations for both internal and external stakeholders.

• Aid in identifying trends or issues related to providers based on contract and billing data.

⛳️ Requirements

• Exceptional communication skills for provider interaction and internal collaboration.

• A minimum of 4 years of experience in provider relations and contract development.

• Outstanding written and verbal communication capabilities.

• Knowledge of reference-based pricing models, single case agreements, and facility contracting principles.

• Strong organizational abilities, with a keen eye for detail and the ability to multitask.

• Comprehensive understanding of Workers Compensation fee schedules, CMS methodology, medical coding, and standard billing practices.

• Proven organizational skills with the capability to manage several priorities effectively.

• Prior experience in commercial healthcare is highly preferred.

• A Bachelor's Degree in a relevant field of study or equivalent professional experience.

🏝️ Benefits

• Comprehensive health coverage including medical, dental, and vision.

• Competitive salary with performance-based incentives.

• Opportunities for professional development and career advancement.

• Flexible working arrangements to promote work-life balance.