Provider Relations and Contract Performance Specialist

Serves as the primary liaison between providers clinical leaders operational teams and the contracting department. Ensures provider understanding of payer contracts payment methodologies operational requirements and value-based performance expectations.

Reports To: Payer Contracting Policy & Regulatory Counsel

Key Responsibilities

Provider Engagement

Build relationships with providers.

Educate providers regarding contractual requirements and reimbursement methodologies.

Contract Performance Support

Assist providers with contract-related issues.

Coordinate escalation of payer operational concerns.

Operational Collaboration

Partner with revenue cycle and finance.

Support implementation of contract changes affecting providers.

Facilitate provider feedback into contracting strategy.

Education & Communication

Develop provider-facing educational materials.

Lead presentations regarding contracting policy disputes/resolutions.

Ensure awareness of payer policy changes.

Qualifications

Bachelors degree required.

5 years healthcare operations contracting provider relations or managed care experience.

Strong facilitation and relationship management skills.

Excellent communication and presentation abilities.