POSITION SUMMARY/RESPONSIBILITIES Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and ...
POSITION SUMMARY/RESPONSIBILITIES Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and ...
Associate, Network Contracting & Services (Texas + West Region)
Dallas, TX · Remote
$87K - $114K/yr
The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build ...
Associate, Network Contracting & Services (Texas + West Region)
Dallas, TX · Remote
$87K - $114K/yr
The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build ...
Radiology Physician
Dallas, TX · On-site
$316K - $395K/yr
Baylor Scott and White Health Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Radiology Physician
Dallas, TX · On-site
$316K - $395K/yr
Baylor Scott and White Health Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Baylor Scott and White Health - Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Baylor Scott and White Health - Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Radiology Physician
$316K - $395K/yr
Baylor Scott and White Health Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Radiology Physician
$316K - $395K/yr
Baylor Scott and White Health Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Physician Radiology - Competitive Salary
$316K - $395K/yr
Baylor Scott and White Health - Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Physician Radiology - Competitive Salary
$316K - $395K/yr
Baylor Scott and White Health - Health Texas Provider Network Medical Group in the North Texas area is seeking BE/BC Diagnostic Radiologists to join a merging radiology practice to grow and develop ...
Senior IP Engineer, Network Engineering
$99K - $136K/yr
Provide regular reports and updates on network performance, incidents, and improvements. Technical Leadership: * Mentor and provide technical guidance to junior network engineers and support staff.
Senior IP Engineer, Network Engineering
$99K - $136K/yr
Provide regular reports and updates on network performance, incidents, and improvements. Technical Leadership: * Mentor and provide technical guidance to junior network engineers and support staff.
Associate, Network Contracting & Services (Texas + West Region)
Dallas, TX · Remote
$87K - $114K/yr
The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build ...
Quick apply
Associate, Network Contracting & Services (Texas + West Region)
Dallas, TX · Remote
$87K - $114K/yr
The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build ...
Senior IP Engineer, Network Engineering
$99K - $136K/yr
Provide regular reports and updates on network performance, incidents, and improvements. Technical Leadership: * Mentor and provide technical guidance to junior network engineers and support staff.
Senior IP Engineer, Network Engineering
$99K - $136K/yr
Provide regular reports and updates on network performance, incidents, and improvements. Technical Leadership: * Mentor and provide technical guidance to junior network engineers and support staff.
Senior IP Engineer, Network Engineering
Houston, TX · On-site
$99K - $136K/yr
Provide regular reports and updates on network performance, incidents, and improvements. Technical Leadership: * Mentor and provide technical guidance to junior network engineers and support staff.
Senior IP Engineer, Network Engineering
Houston, TX · On-site
$99K - $136K/yr
Provide regular reports and updates on network performance, incidents, and improvements. Technical Leadership: * Mentor and provide technical guidance to junior network engineers and support staff.
Associate, Network Contracting & Services (Texas + West Region)
Dallas, TX · On-site
$87K - $114K/yr
The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build ...
Associate, Network Contracting & Services (Texas + West Region)
Dallas, TX · On-site
$87K - $114K/yr
The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build ...
VP, Network Management - Texas, Central, West Markets
Dallas, TX · Remote
$240K - $315K/yr
You will report into the SVP, Network & Provider Management. Work Location: This is a remote position, open to candidates who reside in: Arizona, California, Colorado, Idaho, Illinois, Indiana, Iowa ...
Quick apply
VP, Network Management - Texas, Central, West Markets
Dallas, TX · Remote
$240K - $315K/yr
You will report into the SVP, Network & Provider Management. Work Location: This is a remote position, open to candidates who reside in: Arizona, California, Colorado, Idaho, Illinois, Indiana, Iowa ...
Senior IP Engineer, Network Engineering
Houston, TX · On-site
$99K - $136K/yr
Responsibilities The Senior Network IP Engineer will have a deep understanding of IP networking, extensive hands-on experience with large-scale service provider network infrastructure, and a proven ...
Quick apply
Senior IP Engineer, Network Engineering
Houston, TX · On-site
$99K - $136K/yr
Responsibilities The Senior Network IP Engineer will have a deep understanding of IP networking, extensive hands-on experience with large-scale service provider network infrastructure, and a proven ...
Manages the relationship and performance of the service provider network through direct interaction with the service providers and B2B meetings leveraging insights/takeaways from Centralized Business ...
Manages the relationship and performance of the service provider network through direct interaction with the service providers and B2B meetings leveraging insights/takeaways from Centralized Business ...
Employment is through Health Texas Provider Network (HTPN), the employment group of Baylor Scott & White. The salary is highly competitive, together with generous relocation support, full health ...
Employment is through Health Texas Provider Network (HTPN), the employment group of Baylor Scott & White. The salary is highly competitive, together with generous relocation support, full health ...
Employment is through Health Texas Provider Network (HTPN), the employment group of Baylor Scott & White. The salary is highly competitive, together with generous relocation support, full health ...
Employment is through Health Texas Provider Network (HTPN), the employment group of Baylor Scott & White. The salary is highly competitive, together with generous relocation support, full health ...
Physician Pulmonology - Competitive Salary
$287K - $383K/yr
Employed position through HealthTexas Provider Network (HTPN), Baylor Scott & White employment group in DFW * Built-in large referral network * Candidates in training are welcome to apply Our ...
Physician Pulmonology - Competitive Salary
$287K - $383K/yr
Employed position through HealthTexas Provider Network (HTPN), Baylor Scott & White employment group in DFW * Built-in large referral network * Candidates in training are welcome to apply Our ...
Pulmonology Physician
$287K - $382K/yr
Employed position through HealthTexas Provider Network (HTPN), Baylor Scott & White employment group in DFW * Built-in large referral network * Candidates in training are welcome to apply Our ...
Pulmonology Physician
$287K - $382K/yr
Employed position through HealthTexas Provider Network (HTPN), Baylor Scott & White employment group in DFW * Built-in large referral network * Candidates in training are welcome to apply Our ...
Director, Provider Engagement
Houston, TX · On-site
$144K - $181K/yr
Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: ¿ Medicaid State of Texas Access Reform (STAR) program for low ...
Director, Provider Engagement
Houston, TX · On-site
$144K - $181K/yr
Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: ¿ Medicaid State of Texas Access Reform (STAR) program for low ...
Pulmonology Physician
Fort Worth, TX · On-site
$287K - $382K/yr
Employed position through HealthTexas Provider Network (HTPN), Baylor Scott & White employment group in DFW * Built-in large referral network * Candidates in training are welcome to apply Our ...
Pulmonology Physician
Fort Worth, TX · On-site
$287K - $382K/yr
Employed position through HealthTexas Provider Network (HTPN), Baylor Scott & White employment group in DFW * Built-in large referral network * Candidates in training are welcome to apply Our ...
Provider Network information
What are the typical daily responsibilities of a provider network professional?
A Provider Network professional typically spends their days building and maintaining relationships with healthcare providers, negotiating and renewing contracts, ensuring network adequacy, and responding to provider inquiries or concerns. The role often involves analyzing data on network performance, collaborating with internal teams such as claims, compliance, and credentialing, and conducting outreach to recruit new providers or expand network coverage. You may also monitor regulatory changes and support provider onboarding efforts. This role requires frequent communication, both internally and externally, to ensure quality care delivery and a seamless provider experience.
What are the key skills and qualifications needed to thrive in the provider network position, and why are they important?
To thrive as a Provider Network professional, you need a solid understanding of healthcare operations, provider credentialing, and contract negotiation, typically supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with provider databases, network management systems, and regulatory compliance platforms such as CAQH is often required. Strong relationship-building, problem-solving, and organizational skills set top candidates apart. These abilities are crucial for effectively developing, maintaining, and optimizing provider relationships within health plans or managed care organizations.
What is a provider network?
A Provider Network job involves managing relationships between healthcare providers and insurance companies or healthcare organizations. Responsibilities typically include contracting, credentialing, and ensuring network adequacy to meet patient needs. Professionals in this role negotiate provider agreements, analyze network performance, and ensure compliance with regulations. They play a key role in maintaining access to quality healthcare services for members.

Full-time
Re-posted 21 days ago
University Of Nevada (Reno) rating
8.3
Based on 17 frontline employees who took The Breakroom Quiz
122nd of 615 rated colleges and universities
Job description
POSITION SUMMARY/RESPONSIBILITIES
Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and administrators) of the health plan provider network. This position will build and nurture positive relationships with health plan network participants by providing the on boarding orientation, and delivering guidance and high-quality service through regular engagement by phone and through scheduled in-person visits to targeted provider offices. This position will also coordinate with: Compliance & Quality staff on the re-credentialing process; with Provider Contracting staff for contracting issues or concerns; and will periodically assist the Claims staff with auditing and troubleshooting of provider data to ensure proper claims adjudication. The Provider Relations Representative knows and abides by all organizational and departmental policies, sets personal standards, and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.
EDUCATION/EXPERIENCE
A minimum of five years of related experience in the health care or managed care field of customer service-related work is required. Bachelor’s degree in business, health care, communications, or other related area is preferred. Recent experience as a provider relations representative, member service representative, or relevant claim experience is highly preferred.
LICENSURE
Valid Texas driver’s license as well as a reliable vehicle is required.
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