Provider Network Relations Staff

Key Responsibilities:

• Scout and establish partnerships with healthcare providers.
• Process and monitor provider accreditation requirements.
• Coordinate MOA/contract preparation, signing, and renewal.
• Conduct provider visits, orientations, and re-orientations.
• Maintain accurate provider records and accreditation status.
• Address provider inquiries and concerns.
• Coordinate with Claims, Legal, Accounting, and other departments.
• Monitor provider compliance with company policies and procedures.
• Prepare accreditation, affiliation, and provider network reports.
• Assist in expanding and maintaining the healthcare provider network.

Qualifications

• Bachelor’s degree in Healthcare Management, Business Administration, Marketing, Nursing, Pharmacy, or a related field.
• Experience in HMO, healthcare, insurance, hospital, clinic, or provider relations is an advantage.
• Strong communication, negotiation, and interpersonal skills.
• Good customer service and relationship-management skills.
• Organized and detail-oriented with good documentation skills.
• Able to conduct field visits and meet with healthcare providers.
• Proficient in Microsoft Office/Google Workspace.
• Able to work independently and coordinate effectively with different departments.
• Willing to travel for provider visits and accreditation activities.
• Professional, reliable, and capable of handling confidential provider and company information