Provider Relations Coordinator

Description:

Join our award winning culture as we serve members in your area!

The Provider Relations Coordinator supports the Provider Relations and Quality team by managing credentialing workflows, coordinating compliance activities, and overseeing provider data integrity. Reporting to the Provider Relations and Quality Manager, this role serves as a central point for project coordination across credentialing, development, certification, and quality coding functions. The coordinator ensures timely and accurate reporting, supports provider enrollment compliance, and facilitates communication between internal teams and external partners.

Essential Competencies:

• Take ownership of assigned projects and responsibilities, ensure timely and accurate completion.
• Support provider relations operations by identifying process improvements and implementing solutions that enhance provider and member experiences.
• Apply logic and reasoning to analyze provider data, identify trends, and anticipate challenges.
• Resolve complex issues related to provider relations, credentialing, and compliance through thoughtful decision-making.
• Utilize data to monitor provider performance and compliance, identify opportunities for improvement.
• Demonstrate high standards in work quality, accuracy, and continuous improvement.
• Align actions with organizational goals and contribute to performance improvement initiatives.
• Prepare and interpret reports to inform leadership and guide strategic decision-making.
• Understand and respond to the needs and emotions of others, fostering trust and collaboration.
• Communicate clearly and professionally with internal and external stakeholders.
• Build effective working relationships across teams and with external providers to support network development and issue resolution.
• Participate in meetings and cross-functional initiatives to support departmental and organizational objectives.
• Demonstrate alignment with the mission, values, and strategic direction of the organization.
• Maintain a high level of professionalism and integrity in all interactions.

Requirements:

• Associate degree in healthcare administration, business, or related field preferred, or equivalent combination of education and experience (includes knowledge, skills, and abilities).
• Minimum of two (2) years of experience in provider relations, credentialing, compliance, or healthcare operations.
• Strong organizational and project management skills.
• Proficiency in Microsoft Office and data systems (e.g., Data Clarity, TrueCare).
• Strong listening, verbal, and written communication skills.
• Familiarity with Medicaid, DHS Family Care Contract, and MCO operations preferred.

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Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), Lakeland Care provides long-term care services and supports to eligible frail elders and individuals with physical and intellectual or developmental disabilities to achieve their daily and lifelong goals through Wisconsin’s Family Care program. Currently we serve in 22 counties and have 11 offices in the Central to North East region of Wisconsin.

Our Mission

Empowering individuals. Strengthening communities. Inspiring futures.

Our Vision

To create a world we all want to live in.

Our Core Values

Kindness – We believe kindness is always possible and that no compassionate act is ever wasted.

Inclusion – We believe that open hearts and open minds are the only path to a brighter future.

Trust – We believe that honesty is still in style and that promises still have power.

We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify..