Job Summary
The Provider Relations Representative plays a crucial role in establishing contracts and credentials for healthcare providers to guarantee sufficient network coverage for Medicare Advantage plans. This position also involves informing providers about the functionalities of health plans and overseeing relationships to ensure the maintenance of exceptional quality within the network.
Responsibilities
- Contract and credential healthcare providers to support network adequacy.
- Educate providers about the operations of various health plans.
- Monitor and maintain relationships with providers to ensure high-quality network coverage.
- Ensure compliance with CMS standards in all interactions and processes.
Qualifications
- Bachelor’s degree is required.
- Experience in the healthcare sector, preferably in network development or services.
- Strong skills in negotiation, communication, and organization are essential.
TruHealth provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
