Provider Relations Representative

Summary: Evaluates assigned territories and negotiates contracts with physicians, specialists, ancillary providers and hospitals.

Essential Duties and Responsibilities

• Target potential providers to establish contractual agreements.
• Analyzes and evaluates assigned territories for recruitment needs
• Recruits and contracts physicians, specialists, ancillary providers and hospitals for HN1 with inclusion of all necessary documentation, i.e. credentials, site visits.
• Researches and solves any questions or concerns that providers may have.
• Negotiates contracts for HN1 with inclusion of all necessary documentation, i.e. credentials.
• Works with contracted providers to integrate their services into the overall care delivery network.
• Maintain lines of communications with all internal departments and with all participating providers in enlisting their assistance in referring potential providers in the Network.
• Organize reports for presentation to senior management staff.
• Support other departments as needed.
• Expedites and researches provider’s utilization data with reference to negotiating new rates.
• Responsible for conducting site visits of all newly contracted providers.
• Supports Credentialing Department by assisting with the collection of physician credentials for re-credentialing purposes.
• Maintains and updates physician files.
• Evaluates claim data on recently contracted providers, ensuring contract is profitable for Company.
• Respond to provider inquiries regarding contracts, provider networks and HN1 operations.

Required Education and Experience:

• Associate's degree (A. A.) or equivalent from two-year college or technical school; and two to three years’ experience in physician's office, HMO's or other Health Care institutions

Job Type: Full-time

Pay: $55,000.00 per year

Ability to Relocate:

• Fort Lauderdale, FL 33316: Relocate before starting work (Required)

Work Location: Hybrid remote in Fort Lauderdale, FL 33316