provider relations manager

Molina Healthcare

***Remote and must live in Illinois or Missouri***
 
JOB DESCRIPTION
 
Job Summary
 
Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network specifically FQHC's, RHC's, and DME. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.
 
Essential Job Duties
 
<ul>
<li>Successfully engages the plan's highest priority, high-volume and strategic complex provider community providers (including value-based payment (VBP) and other alternative payment method (APM) contracts to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.</li>
<li>Serves as the primary point of contact between Molina health plan and the for non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.</li>
<li>Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.</li>
<li>Resolves complex provider issues that may cross departmental lines including contracting, finance, quality, operations, and may involve senior leadership.</li>
<li>Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.</li>
<li>Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.</li>
<li>Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.</li>
<li>Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).</li>
<li>Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).</li>
<li>Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).</li>
<li>Oversees and demonstrates accountability for provider satisfaction survey results.</li>
<li>Develops and deploys strategic network planning tools to drive provider relations and contracting strategy across the enterprise.</li>
<li>Facilitates strategic planning and documentation of network management standards and processes (effectiveness is tied to financial and quality indicators).</li>
<li>Works collaboratively with functional business unit stakeholders to lead and/or support various provider services functions with an emphasis on developing and implementing standards and best practice sharing across the organization.</li>
<li>Navigates the matrix team environment including: new markets provider/contract support services, resolution support, and national contract management support services.</li>
<li>Serves as a subject matter expert for the provider relations function.</li>
<li>Provides training, mentoring, and support to new and existing provider relations team members.</li>
<li>Role requires 80%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).</li>
</ul>
Required Qualifications
 
<ul>
<li>At least 6 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience.</li>
<li>Strong understanding of the health care delivery system, including government-sponsored health plans.</li>
<li>Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.</li>
<li>Previous experience with community agencies and providers.</li>
<li>Strong organizational skills and attention to detail.</li>
<li>Ability to manage multiple tasks and deadlines effectively.</li>
<li>Experience with preparing and presenting formal presentations.</li>
<li>Strong interpersonal skills, including ability to interface with providers and medical office staff.</li>
<li>Ability to work in a cross-functional highly matrixed organization.</li>
<li>Strong verbal and written communication skills.</li>
<li>Microsoft Office suite and applicable software programs proficiency.</li>
</ul>
Preferred Qualifications
 
<ul>
<li>Management/leadership experience.</li>
<li>Contract negotiation experience.</li>
</ul>
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
 Pay Range: $63,435 - $123,699 / ANNUAL
 <ul>
<li>Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.</li>
</ul>

Provider Relations Manager (FQHC's, RHC's, & DME)

Altea Healthcare

Job Title: Operations ManagerJob Type: Full -Time (Mon-Fri)Location: Hybrid role in IndianaCompensation: $75,000 - $90,000 per yearWe are seeking a dedicated Operations Manager to support the Operations Director in overseeing the functionality of our market and the facilities within it. This role is essential in ensuring the seamless operation of our post-acute skilled nursing facilities, focusing on optimizing performance, enhancing patient care, and maintaining operational excellence.Key Responsibilities:<ul><li>Collaborate with the Operations Director to develop and implement operational strategies and goals for the facilities within the market.</li><li>Monitor and analyze facility performance metrics, including quality of care, patient satisfaction, and financial performance.</li><li>Support the coordination of operational activities and resources to ensure efficient and effective facility management.</li><li>Assist in the development and implementation of policies, procedures, and best practices to ensure compliance with regulatory requirements and industry standards.</li><li>Facilitate communication and collaboration between facility staff, vendors, and other stakeholders.</li><li>Address and resolve operational issues, ensuring timely and effective solutions.</li><li>Contribute to the development of staff training programs and performance improvement initiatives.</li><li>Maintain up-to-date knowledge of industry trends, regulations, and best practices.</li></ul>Qualifications:<ul><li>Bachelor&rsquo;s degree preferred; relevant experience may be considered in lieu of degree.</li><li>Minimum of 1 year experience in provider relations.</li><li>Minimum of 2 years experience in a post-acute care setting/ assisted living.</li><li>Minimum of 1 year experience in healthcare operations.</li><li>Strong understanding of healthcare regulations, standards, and operational best practices.</li><li>Excellent communication, leadership, and problem-solving skills.</li><li>Ability to work independently and manage multiple priorities in a hybrid/remote environment.</li><li>Proficient in Microsoft Office Suite and experience with healthcare management software preferred</li></ul>Job Type: Full-timePay: $75,000.00 - $90,000.00 per yearBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Paid time off</li><li>Vision insurance</li></ul>Experience:<ul><li> post-acute/ assisted living: 2 years (Required)</li><li>Provider Relations: 1 year (Required)</li><li>Healthcare Operations : 1 year (Required)</li></ul>Ability to Commute:<ul><li>Indianapolis, IN (Required)</li></ul>Ability to Relocate:<ul><li>Indianapolis, IN: Relocate before starting work (Required)</li></ul>Willingness to travel:<ul><li>50% (Preferred)</li></ul>Work Location: Hybrid remote in Indianapolis, IN

Operations Manager-Post Acute Skilled Nursing

American Advanced Management, Inc

<div>Senior Manager, Practice Operations &amp; Provider Relations
Position Summary
Provides strategic and operational leadership for a hospital-owned multi-specialty surgical practice while serving as a key liaison to the hospital C-suite (CEO, COO, CNO, CMO). Oversees clinic operations, drives provider engagement and satisfaction, and supports executive initiatives to ensure alignment between ambulatory services and organizational goals.
Key Responsibilities
Practice Operations Leadership<ul><li>
Direct day-to-day operations of a multi-specialty surgical clinic, ensuring efficient workflows, patient access, and high-quality care delivery</li><li>
Develop and implement operational policies, procedures, and performance standards aligned with hospital objectives</li><li>
Oversee staffing models, clinic scheduling, and resource allocation to optimize productivity and patient throughput</li><li>
Monitor key performance indicators (KPIs) including volume, revenue cycle metrics, patient satisfaction, and quality outcomes</li><li>
Collaborate with revenue cycle, billing, and compliance teams to ensure accurate documentation, coding, and reimbursement</li><li>
Ensure regulatory compliance with CMS, Joint Commission, and state/federal requirements</li></ul>
Provider Relations &amp; Engagement<ul><li>
Serve as the primary point of contact for physicians and advanced practice providers within the hospital and surgical practice</li><li>
Foster strong provider relationships to support recruitment, onboarding, retention, and satisfaction</li><li>
Address provider concerns, workflow issues, and operational barriers in a timely and effective manner</li><li>
Partner with medical leadership to align clinical goals with operational strategy</li><li>
Coordinate provider meetings, communications, and performance feedback processes</li></ul>
Executive Liaison to C-Suite<ul><li>
Act as a strategic liaison between operations and executive leadership (CEO, COO, CNO, CMO)</li><li>
Support execution of hospital-wide initiatives within the clinic and hospital settings</li><li>
Prepare executive-level reports, presentations, and operational analyses for leadership review</li><li>
Coordinate communication and follow-through on key directives from the C-suite</li><li>
Participate in strategic planning, service line development, and growth initiatives</li></ul>
Strategic &amp; Business Development<ul><li>
Identify opportunities for service line expansion, efficiency improvements, and market growth</li><li>
Support physician alignment strategies and integration of new providers or specialties</li><li>
Actively engage in Direct Marketing activities to enhance referral networks and community presence</li><li>
Lead or support special projects related to ambulatory growth, surgical services, and patient access</li></ul>
Quality, Compliance &amp; Patient Experience<ul><li>
Promote a culture of safety, quality, and patient-centered care</li><li>
Oversee implementation of quality improvement initiatives and monitor outcomes</li><li>
Ensure adherence to clinical and operational compliance standards</li><li>
Address patient concerns and improve overall patient experience metrics</li></ul>
Leadership &amp; Team Development<ul><li>
Supervise clinic management and administrative staff</li><li>
Provide coaching, performance management, and professional development</li><li>
Foster a collaborative, accountable, and high-performing team environment</li></ul>
Core Competencies<ul><li>
Healthcare operations &amp; ambulatory practice management</li><li>
Executive communication &amp; organizational leadership</li><li>
Provider relations &amp; physician engagement</li><li>
Strategic planning &amp; performance improvement</li><li>
Regulatory compliance &amp; quality management\\</li></ul>
Required:<ul><li>
Bachelor&rsquo;s degree in Healthcare Administration, Business, Nursing, or related field</li></ul>
Preferred:<ul><li>
Master&rsquo;s degree (MHA, MBA, MSN)</li></ul></div>

SENIOR MANAGER, PRACTICE OPERATIONS & PROVIDER RELATIONS

AlignRx LLC

AlignRx is a Public Benefit LLC (PBLLC)&mdash;a for-profit limited liability company that is intended to produce a public benefit and to operate in a sustainable manner. We are the only PSAO to establish itself as this type of legal entity, as we are deeply committed to promoting the interests of community pharmacies. You can count on us to be transparent, accountable, and passionate.As an independently owned PSAO, we want community pharmacy owners to have maximum flexibility in their buy-side choices so they can maintain control over their business. AlignRx does not require pharmacy owners to purchase from a specific wholesaler or buying group. This benefit is just one more reason that community pharmacies experience peace of mind knowing our interests are in sync with theirs.Our mission is to support community pharmacy by offering innovative products and services that are best in class and designed to promote the pharmacies we serve as essential healthcare providers resulting in improved patient care and outcomes.Job SummaryWithin the Pharmacy Services Department, the Provider Relations Representative is responsible for providing support to pharmacy members seeking assistance or information regarding: contracted PBMs and health plans, payment rates and reimbursement status, claims processing and reconciliation, and all AlignRx programs and services. The position utilizes tools, resources, and guides to provide prompt and accurate addressing of questions and resolution of issues. The Provider Relations Representative often works closely with the PBM Account Executive and Senior PBM Account Executive on PBM and health plan issues.Essential Job Functions1. Serve as the front-line contact for AlignRx pharmacy members requesting information on, assistance with, or explanation of claims processing issues, AlignRx PSAO contracts, pharmacy not-contracted, direct contracting, claims pricing, claims reconciliation, and missing data, etc. (requests received via pharmacy member service calls, emails, or faxes).2. Maintain knowledge of existing and newly launched AlignRx programs and services, including mastering content of AlignRx programs and services guides for the purpose of servicing pharmacy members.3. Conduct data pulls to validate contract information.4. Follow up on eRecon and Central Pay issues for pharmacy members.5. Follow defined work plans and leadership direction to meet due dates when addressing pharmacy member concerns or adverse issues.6. Abide by department workflow, policies, and procedures.7. Remain current on pharmacy industry trends and aware of AlignRx pharmacy member business needs and concerns.8. Monitor and address issues from Customer Support email box.9. Document call and work activity in the Pharmacy Data Management System (PDMS) and review Daily Notes report to ensure follow-up and resolution.10. Attend and actively participate in Provider Relations team meetings.11. Provide support to other team members, as needed.Additional Responsibilities<ul><li>Perform other duties or projects as assigned by senior management.</li></ul>Minimum Qualifications for Consideration<ul><li>Bachelor&rsquo;s degree in a business-related field preferred.</li><li>Two to three years as a pharmacy technician in a retail pharmacy environment.</li></ul>Knowledge, Skills, and Abilities:<ul><li>Excellent verbal and written communication skills</li><li>Good interpersonal skills: able to work and communicate effectively with all levels of co-workers, clients, and other external contacts</li><li>Strong organizational and time management skills</li><li>Dependable with good attendance and adherence to timelines and schedules</li><li>Strong analytical skills</li><li>Good problem-solving skills</li><li>Consistent follow-through on issue resolution</li><li>Resourceful, with the ability to take initiative in development and completion of projects</li><li>Strong sense of customer service</li><li>Basic computer knowledge through effective use of a personal computer including Microsoft Office applications, specifically: file management skills, Internet, Microsoft Windows, database, word processing (Word), spreadsheets (Excel), presentation software (PowerPoint), graphics</li><li>Knowledge of and experience in the pharmacy and healthcare industry regarding terminology and retail pharmacy operations, including understanding of how and why pharmacy claims process (e.g., calculation of copayments, pricing hierarchies)</li><li>Basic drug knowledge and understanding of Therapeutic Categories (TC), Multi-Source Indicators (MSI), Generic Product Identifier (GPI), Generic Code Number (GCN), Drug/claim statuses: Paid vs. Captured; PDL/NPDL; &ldquo;F&rdquo; &ndash; Formulary (paid) vs. &ldquo;G&rdquo; &ndash; Non-formulary paid</li></ul>Physical Requirements/Working Conditions<ul><li>Sedentary work, requiring the following physical activities: sitting for long periods of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking, hearing, and visual acuity</li><li>Lifting of up to 20 pounds of paper supplies or minor office equipment</li><li>Conducting work in a business-type environment (e.g., desk, table) that can facilitate the use of two computer monitors</li><li>Remote</li></ul>SalaryStarting at $20.00 an hour, based on experienceBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Tuition reimbursement</li><li>Vision insurance</li></ul>For more information about our company, visit alignrx.orgNOTE: The above statements are intended to describe the general nature and level of work performed by an employee in this position. These statements are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees in this position.AlignRx is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate unique differences of our employees, knowing diversity drives innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by applicable laws or regulations.Pay: From $20.00 per hourExperience:<ul><li>Pharmacy technician in a retail environment: 2 years (Required)</li></ul>Work Location: Remote

Provider Relations Representative

Humana

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing provider performance and advancing Humana's mission to deliver high-quality healthcare. You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and strong relationship-building. This role offers a unique opportunity to leverage your expertise in healthcare provider relations to influence operational decisions and support the overall success of the organization. You will operate with a high degree of independence, often determining methods/approach to work and establishing own work priorities and timelines. Your work consists of tasks that are moderately complex, requiring minimal instructions to achieve solutions. You may provide coaching and/or review the work of lower-level associates. You will make decisions on moderately complex issues; exercises discretion and judgment over policies and own approach/priorities. Your work impacts the achievement of results for the department and begins to influence the department's strategy.
Key Responsibilities:<ul><li>
Provider Collaboration: Work with providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor performance toward these goals.</li><li>
Stars/Quality Program Expertise: Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience. Collaborate to develop tailored action plans and communicate actionable insights to improve performance.</li><li>
Performance Improvement: Actively monitor and analyze provider performance data to identify areas for improvement. Implement strategies to enhance outcomes and provide ongoing support and guidance to providers.</li><li>
Resource Liaison: Act as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools. Facilitate communication between providers and internal teams to ensure seamless access to necessary resources and support.</li><li>
Reward Programs: Educate provider groups on reward programs and target metrics, collaborating to achieve established goals. Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed.</li><li>
Provider Abrasion Resolution: Resolve provider abrasion issues effectively, ensuring a positive and collaborative relationship between Humana and its providers. Implement strategies to minimize provider abrasion and enhance overall satisfaction.</li><li>
Internal Collaboration: Partner with internal teams to track and report on market performance, ensuring alignment with organizational goals. Collaborate with cross-functional teams to drive initiatives that support provider performance</li></ul><h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Required Qualifications<ul><li>
Bachelor's degree in business, finance, health care/administration, nursing (BSN), or a related field, or equivalent work experience.</li><li>
Experience with Medicare Risk Adjustment and/or medical coding.</li><li>
Experience with Medicare and/or managed care.</li><li>
Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System, and CAHPS/HOS survey system.</li><li>
Ability to drive interoperability and understanding of Consumer/Patient Experience.</li><li>
Proven experience building relationships with physician groups and influencing execution of recommended strategies.</li><li>
Strong communication and presentation skills, both verbal and written, with experience presenting to internal and external customers, including high-level leadership.</li><li>
Focus on process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care.</li><li>
Comprehensive knowledge of Microsoft Office Word, Excel, and PowerPoint.</li><li>
Candidates must live in WA, MT, or UT.</li><li>
Willingness to travel a minimum of 25% within region.</li><li>
Must be able to work during 8:00 a.m. &ndash; 5:00 p.m. Monday &ndash; Friday according to Pacific (PST) or Mountain (MST) time zones.</li></ul>
Additional Information
Work At Home / Internet Statement:
To ensure Home or Hybrid Home/Office employees&rsquo; ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:<ul><li>
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.</li><li>
Satellite, cellular and microwave connection can be used only if approved by leadership.</li><li>
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.</li><li>
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.</li><li>
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.</li></ul>
SSN Alert Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana&rsquo;s secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$78,400 - $107,800 per year 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Sr. Network Performance Professional

Blue Cross and Blue Shield of Minnesota

<div>Hybrid | Eagan, Minnesota
<div>Job ID: R0006346 Career Area: Legal Date Posted: 03/19/2026</div><div>
</div><div>About Blue Cross and Blue Shield of Minnesota 
 
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. 
The Impact You Will Have
The Senior Provider Partner, Behavioral Health is dedicated to strengthening and optimizing partnerships specifically within the Behavioral Health provider community. This role builds and manages relationships across a diverse mix of Behavioral Health providers&mdash;including small practices, mid-sized organizations, and select large networks&mdash;while leading complex contract negotiations within approved parameters. With a deep understanding of Behavioral Health delivery systems, this role drives initiatives that elevate network performance and advance organizational goals. Serving as a trusted advisor to both Behavioral Health providers and internal teams, the Senior Provider Partner leverages strong negotiation expertise, data analysis, and market insights to create mutual value and effectively support enterprise priorities.
Your Responsibilities
<ul><li>Build and manage provider relationships, serving as the primary point of contact for assigned providers and ensuring alignment with organizational goals and business strategies.</li><li>
Lead negotiations for complex provider contracts, meeting budget and timeline requirements; prepare proposals using approved templates and historical practices and incorporate market trends and benchmarks to strengthen negotiation outcomes.</li><li>
Analyze complex contracting and financial data in collaboration with Network Finance and Analytics; translate insights into actionable solutions for non-standard requests and business challenges.</li><li>
Prepare detailed reports for leadership on contract status, provider performance, and negotiation progress; deliver clear summaries of outcomes and recommendations.</li><li>
Develop, implement, and execute annual work plans for assigned providers to support strategic objectives and performance targets.</li><li>
Represent the provider perspective on cross-functional teams; lead or participate in initiatives to design innovative network strategies and inform new product or operational improvements.</li><li>
Ensure compliance with regulatory requirements, accreditation standards, and internal contract administration policies across all activities.</li><li>
Mentor and coach team members on negotiation strategies, contract interpretation, and best practices; provide guidance to junior teammates to build capability and consistency.</li></ul>
Required Skills and Experience
<ul><li>5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.</li><li>
High school diploma (or equivalency) and legal authorization to work in the U.S.</li></ul>
Preferred Skills and Experience
<ul><li>Bachelor's degree.</li><li>
Exhibits strong relationship management skills.</li><li>
Flexible in handling work flow and in working with other stakeholders.</li><li>
Displays strong ability to lead cross-functional teams.</li><li>
Demonstrated project management skills.</li><li>
Excellent communications and interpersonal skills (internal/external).</li><li>
Ability to work across systems and functions to facilitate solutions and capabilities development.</li><li>
Demonstrated creativity and curiosity in solution development with strong sense of urgency.</li><li>
Positive thinker/self starter.</li><li>
Skillful negotiator, ability to influence internal and external customers.</li></ul>
Compensation and Benefits:
Pay Range: $102,400.00 - $138,300.00 - $174,200.00 Annual
Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.
We offer a comprehensive benefits package which may include:<ul><li>
Medical, dental, and vision insurance</li><li>
Life insurance</li><li>
401k</li><li>
Paid Time Off (PTO)</li><li>
Volunteer Paid Time Off (VPTO)</li><li>
And more</li></ul> 

Role Designation
Hybrid
Anchored in Connection
Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week &ndash; most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.
Equal Employment Opportunity Statement 
 
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. 
 
Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com. 
 
Blue Cross&reg; and Blue Shield&reg; of Minnesota and Blue Plus&reg; are nonprofit independent licensees of the Blue Cross and Blue Shield Association.</div></div>

Senior Provider Partner, Behavioral Health

Behavior Treatment & Analysis

<div>Human Resources Generalist 
Industry: Healthcare / Autism &amp; Developmental Services 
Location: California (On-Site)
<h3 class="jobSectionHeader">About Us</h3>
BTA is a provider of high-quality therapeutic services for children with autism and other developmental disabilities. We are committed to supporting families, empowering staff, and fostering a positive, mission-driven work environment.
As we continue to grow, we are seeking a Human Resources Generalist to support daily HR operations and ensure a consistent and compliant employee experience.
<h3 class="jobSectionHeader">Position Summary</h3>
The Human Resources Generalist supports the day-to-day execution of HR functions, including onboarding, employee relations, compliance, and HR administration. This role works closely with the HR Manager to implement processes, support employees, and ensure adherence to company policies and California labor laws.
This position is hands-on and detail-oriented, focused on execution rather than strategic leadership.
<h3 class="jobSectionHeader">Key Responsibilities</h3>
<h4 class="jobSectionHeader">HR Operations &amp; Administration</h4>
<ul><li>Support daily HR operations and ensure timely execution of HR processes.
</li><li>Maintain accurate employee records, files, and HR documentation.
</li><li>Assist in implementing HR policies, procedures, and internal guidelines.
</li><li>Ensure data accuracy in HRIS systems.
</li></ul><h4 class="jobSectionHeader">Recruitment &amp; Onboarding</h4>
<ul><li>Coordinate recruitment processes including scheduling interviews and candidate communication.
</li><li>Support onboarding by preparing new hire documentation and ensuring a smooth onboarding experience.
</li><li>Track onboarding progress and ensure compliance with hiring requirements.
</li></ul><h4 class="jobSectionHeader">Employee Relations</h4>
<ul><li>Serve as a point of contact for employee questions regarding HR policies and procedures.
</li><li>Support employee relations matters by documenting issues and escalating to HR Manager as needed.
</li><li>Assist in disciplinary processes, investigations, and follow-ups under HR Manager guidance.
</li></ul><h4 class="jobSectionHeader">Compliance &amp; Documentation</h4>
<ul><li>Ensure compliance with company policies and applicable California labor laws.
</li><li>Maintain and track required certifications, background checks, and employee credentials.
</li><li>Assist with audits and ensure proper documentation is in place.
</li></ul><h4 class="jobSectionHeader">Payroll &amp; Workforce Support</h4>
<ul><li>Support payroll processes by reviewing timekeeping and ensuring accuracy of employee data.
</li><li>Assist with employee status changes, leave tracking, and updates in HR systems.
</li><li>Coordinate offboarding processes, including documentation and system updates.
</li></ul><h4 class="jobSectionHeader">Organizational Support</h4>
<ul><li>Support initiatives that promote employee engagement and a positive work environment.
</li><li>Assist in coordinating trainings, meetings, and HR-related communications.
</li><li>Provide general administrative support to the HR department.
</li></ul><h3 class="jobSectionHeader">Qualifications</h3>
<ul><li>Bachelor's degree in Human Resources, Business Administration, Psychology, or related field preferred.
</li><li>2&ndash;3 years of experience in Human Resources or administrative support role.
</li><li>Basic knowledge of HR practices and employment laws (California knowledge is a plus).
</li><li>Bilingual English/Spanish preferred, but not.
</li><li>Strong organizational and communication skills.
</li><li>Ability to handle sensitive and confidential information.
</li><li>Detail-oriented with strong follow-through.
</li><li>Experience with HRIS systems preferred.</li></ul></div>

HR Generalist

Search 10000+ Provider relations manager jobs near you this March. New roles added regularly across leading industries. Apply today.