provider relations specialist

FMOL Health

<div>The Human Resources Provider Relations Specialist contributes with both hands-on and strategic support of our managers and providers, physicians and Advanced Practice Providers (APPs), through performance management and workplace conflict issues to cultivate an innovative, high-performing, and inclusive culture. Responsible for advising on and conducting sensitive investigations of potential policy and/or Code of Conduct violations, developing Provider Relations (PR) capabilities and leading initiatives to strengthen PR competency development across assigned divisions/group(s). The position requires the ability to quickly issue-spot complex employment and PR matters and to develop and implement sound, balanced, and thorough solutions aligned with our cultural values.</div>
 <div>1. Implements effective, fair and consistent provider relations strategies.
 
2. Provides coaching and consultation on conflict resolution, facilitates problem solving, administers performance improvement plans and progressive discipline procedures.
 
3. Ensures adverse employment actions (discipline, suspension, termination) comply with policy, regulations, and laws, in addition to being aligned with company mission &amp; values while collaborating with Franciscan Health Physicians (FHP) HR Executive prior to implementing recommended action.
 
4. Independently conducts HR investigations; documents findings and makes recommendations that drive the appropriate actions to close cases in a timely manner.
 
5. Maintains PR data &amp; ensures tracking system is updated accurately.
 
6. Tracks, trends &amp; analyzes PR data and develops strategies in collaboration with FHP HR Leaders to address ER trends.
 
7. Represents FMOL/FHP in unemployment filings, hearings, and appeals.
 
8. Partners with legal, risk, compliance, HR Business Partners and HR Centers of Excellence as needed.
9. Establishes best practices and frameworks for provider investigations and performance management conversations.
 
10. Improves, socializes and implements HR processes, approaches, guidelines, practices and operating procedures related to provider relations.
 
11. Partners with Employee Relations community across region/ health system to ensure consistency in practices &amp; processes.
 
12. Create presentations &amp; conducts manager training related to provider relations topics (Harassment, discrimination, progressive disciplinary process, policies, best practices, etc.) and other provider relations topics that promote positive and productive relationships between leaders and providers.
 
13. Leads more complex PR cases and escalates cases to FHP HR leadership as needed.
 
14. Provides ongoing competency development. training to FHP Leaders and Medical Directors
 
15. Escalates all termination requests for assigned group(s) to FHP HR leadership, Chief Physician Officer (CPO)and Legal for final review.
 
16. Provides day to day direction and support to group of Employee Relations Specialist 1 &amp; 2.
17. Performs other duties as assigned or requested.</div>
 <div>Experience: 7 year's experience in employee relations, labor relations and/or business partner role
Education: Bachelor's Degree
Other Skills and Abilities:
Excellent organizational skills and attention to detail, able to juggle and prioritize multiple tasks simultaneously while delivering on commitments; Skill in writing concise, clear, relevant and persuasive documents, including correspondence, case analyses, investigative reports; Excellent public speaking, training, and/or leadership communication skills; Ability to quickly connect with people across a wide variety of backgrounds; Comfortable in a fast-paced environment and able to manage through ambiguity and change. Knowledge of applicable state and federal laws to ensure legal compliance (EEOC, DOL, ADA, FMLA, FLSA, HIPPA).</div>

Provider Relations Specialist

Aspire Allergy & Sinus

<div><h3 class="jobSectionHeader">Description</h3><div> 
Our PATIENTS make us. Our VALUES guide us. Our CULTURE defines us. Our TEAM sets us apart. We are better together!</div><div></div><div> 
Aspire Allergy &amp; Sinus is a group of highly experienced Allergists, Surgeons, Medical Providers and Support Teams. By redefining the allergy and sinus care model that is geared toward a better patient experience, we allow our specialists to do what they do best: diagnose, treat and cure patients who suffer from allergy and sinus problems. We live by the guiding principles that underscore what we do and how we do it: Deliver a memorable experience, practice precision everywhere, share responsibility &amp; exemplify integrity. We are headquartered in Austin, Texas and have over 60 clinics stretching across Texas, Florida, New Mexico, Arizona, and Colorado! Do not miss out on the lifetime opportunity to help Aspire scale and reach more patients in more states.</div><div>
 
We have an exciting opportunity for a motivated, outgoing and results-driven Provider Relations Specialist for the Tucson area. You will help Aspire Allergy build relationships with referring physicians in the community, provide value through education on service lines and ultimately drive patient referrals into Aspire clinics. 
 
Flexible Schedule: This role offers the option to work between 30&ndash;40 hours per week based on your preference.</div> 
<h3 class="jobSectionHeader">
Key Responsibilities</h3> 
<ul>
<li>
Utilize physician target lists to make face to face presentations to community physicians in the fields of family practice, internal medicine and pediatrics that have patient referral potential</li>
<li>Consistent KPI attainment of expected weekly/monthly call activity as designated</li>
<li>Utilize Salesforce to manage and track provider interactions, sales leads, and opportunities, ensuring accurate and up-to-date information</li>
<li>Educate referring providers on Aspire Allergy &amp; Sinus services and therapies with promotional items and selling materials</li>
<li>Build relationships with referring providers and staff to ensure a line of consistent referrals</li>
<li>Promote Aspire providers that include Allergists, Physician Assistants, Nurse Practitioners and Surgeons in the community through meet and greets, breakfasts and lunches</li>
<li>Establish relationships with Aspire providers and teams in your local market, aiming to visit their office locations once a month for feedback on their experiences and communicating any issues or concerns to the Director of Provider Relations.</li>
<li>Ongoing communication and collaboration with marketing team &amp; Director of Provider Relations</li>
<li>Other Duties as assigned by your manager</li></ul><div> 
</div> 
<h3 class="jobSectionHeader">Requirements</h3> 
<ul>
<li>
2+ years medical sales experience calling on healthcare providers within an assigned territory (Pharmaceutical Sales experience is a plus)</li>
<li>Bachelor's Degree</li>
<li>Ability to execute sales presentations on Aspire Allergy &amp; Sinus medical services and treatments to healthcare providers and their staff</li>
<li>Ability to establish long term relationships with referral sources</li>
<li>Ability to work autonomously to accomplish goals and meet KPI targets</li>
<li>Ability to effectively educate and communicate medical services and treatments to healthcare providers and their staff</li>
<li>Independently generate patient referrals and drive business growth</li>
<li>Basic proficiency with Salesforce is a plus but not required</li>
<li>Must have registered and insured motor vehicle and proof of liability insurance</li>
<li>Valid State Driver's License with an acceptable motor vehicle driving record</li>
<li>Must be legally authorized to work in the United States</li>
<li>Ability to travel to areas of your assigned region</li></ul><div></div><h3 class="jobSectionHeader"> 
Benefits</h3> 
<ul>
<li>
Fixed Salary plus a quarterly bonus based on performance goals</li>
<li>Mileage reimbursement</li>
<li>Medical, Dental and Vision Insurance</li>
<li>Generous Paid Time Off and Paid Holidays</li>
<li>401(k) + Generous Employer Match</li>
<li>Life Insurance</li>
</ul><div>... AND MORE!</div><div></div><h3 class="jobSectionHeader"> 
About Aspire Allergy &amp; Sinus</h3><div>
We are a collective unit of passionate people who have come together to reinforce our cause: curing patients who suffer from allergy and sinus problems. We take great pride in hiring enthusiastic, talented individuals who believe in our cause and want to grow our company and its employees. 
 
We recognize that we thrive and achieve advanced patient care because of our ever-growing team. We are better together and there has never been a better time to help make a difference! Aspire currently stretches among numerous clinics throughout Arizona, Colorado, Florida, New Mexico, and Texas, with plans for several more additions. Do not miss out on the lifetime opportunity to help Aspire scale up and reach more patients in more states.</div></div>

Provider Relations Specialist (30–40 hrs/week)

Dakota Autism Center

About the role Dakota is seeking a driven Community Outreach Specialist to grow our ABA program. Your primary mission: build referral relationships with healthcare providers, schools, and community organizations to generate qualified client leads for Dakota to serve.This is a community-facing, relationship-driven role that makes a real impact &mdash; connecting children and families to life-changing autism and developmental services.What you'll doReferral development &amp; lead generation<ul><li>Build and maintain a referral network with pediatricians, developmental specialists, neurologists, and primary care providers serving children ages 0&ndash;21</li><li>Cultivate partnerships with school districts, ECSE teams, Head Start, and Early Intervention coordinators</li><li>Connect with county social services, DHS case managers, and disability resource navigators to generate client leads</li><li>Conduct outreach visits, presentations, and attend community events to position Dakota as the preferred EIDBI provider</li><li>Track all leads, referrals, and conversions in CRM &mdash; updated within 24 hours of each contact</li><li>Follow up on all referral leads to support intake and enrollment of eligible clients</li></ul>Community education &amp; provider relations<ul><li>Educate referring providers on client eligibility, the CMDE process, and Dakota's service offerings</li><li>Represent Dakota at health fairs, disability expos, school transition events, and provider networking meetings</li><li>Help families navigate access to EIDBI services and reduce enrollment barriers</li></ul>Compliance &amp; coordination<ul><li>Operate in full compliance with MN Statute 256B.0949, HIPAA, and DHS EIDBI program rules</li><li>Collaborate with leadership, intake team, and clinical staff to ensure smooth client onboarding</li><li>Report referral pipeline data and market intelligence to leadership regularly</li></ul>Job Types: Full-time, Part-time, Temporary, ContractPay: $30.00 - $35.00 per hourExpected hours: 20.0 &ndash; 40.0 per weekBenefits:<ul><li>Flexible schedule</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Experience:<ul><li>Behavioral health: 1 year (Preferred)</li><li>Outreach: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li><li>Spanish (Preferred)</li><li>Hmong (Preferred)</li><li>Somali (Preferred)</li></ul>Work Location: On the road

Community Outreach Specialist

Healgen Scientific

<div></div><div>Healgen Scientific is seeking an experienced Vendor Relations Specialist to join our team on a 1099 contract basis for a 6-month engagement.
The Vendor Relations Specialist is responsible for sourcing and onboarding new vendors, negotiating pricing and contracts, and maintaining strong vendor relationships to support Healgen's procurement needs. This role ensures the company acquires the raw materials, services, and supplies necessary for operations at the best possible value and quality. 
DUTIES AND RESPONSIBILITIES<ul><li>Develop and maintain strong, collaborative relationships with vendors by providing information and support to resolve issues efficiently.</li><li>Work with cross-functional internal departments to understand requirements and source suitable vendors for assigned tasks.</li><li>Act as a liaison between external vendors and internal departments by facilitating meetings and ensuring effective communication.</li><li>Research vendor qualifications and verify references as part of the vendor onboarding process.</li><li>Assist in presenting proposals, quotes, pricing comparisons, and market analyses to management.</li><li>Negotiate contracts and agreements with vendors to ensure favorable terms and pricing.</li><li>Provide contract summaries and ensure contract execution in accordance with company policy.</li><li>Monitor delivery timelines and provide status updates to relevant internal departments.</li><li>Assist the Chief Supply Chain Officer with vendor management, recordkeeping, and filing.</li><li>Work closely with the Accounting team to ensure proper documentation is in place for timely vendor payment processing.</li><li>Collaborate with the Quality department to monitor and update the Approved Vendor List (AVL) as needed.</li><li>Perform other duties as assigned.</li></ul> 
QUALIFICATIONS<ul><li>Bachelor's degree in Supply Chain Management, Business Administration, or a related field.</li><li>Minimum of 1 year of experience in a similar role.</li><li>Proficient in developing and executing vendor engagement and procurement strategies.</li><li>Strong attention to detail with the ability to manage multiple projects and competing priorities.</li><li>Excellent interpersonal and negotiation skills; adept at building relationships with internal teams and external vendors.</li></ul> 
This is a 1099 independent contractor position. Interested candidates should submit a resume and desired rate for consideration.</div>

Vendor Relations Specialist (1099 Contractor)

SKYGEN

<div>Important things YOU should know:
<ul><li>Fully remote opportunity
</li><li>Training schedule 8:00am - 4:30pm Monday &ndash; Friday CST
</li><li>Work schedule (after training): 10:00am - 6:30pm CST Mon - Fri
</li><li>Hours of operation: 7:00am - 10:00pm CST Monday - Friday so shift could flex based on business need
</li><li>$2.00/hour differential on Mon/Tues
</li><li>Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31
</li>Exceptional professional growth in a fun rewarding environment 
<li>
</li></ul>What will YOU be doing for us?
Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer &ndash; always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.
What will YOU be working on every day?
<ul><li>Servicing our Dental and Vision inbound callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area,
</li><li>Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests.
</li><li>Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution.
</li><li>Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information.
</li><li>Act as liaison between our organization and the client&rsquo;s Member Services staff to resolve issues such as eligibility and filing appeals and grievances.
</li><li>Provide updates to providers with questions regarding the status of their credentialing application.
</li><li>Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available.
</li><li>Ensure all calls are answered according to company and client guidelines.
</li><li>Accurately document call information and resolution in our internal systems.
</li><li>Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported.
</li><li>Properly identify issues that need to be escalated appropriately to the leadership team.
</li></ul>Additional Responsibilities:
<ul><li>Provide recommendations on system enhancements and process improvements to management.
</li><li>Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues.
</li>Participate in departmental projects when applicable. 
<li>
</li></ul>What qualifications do YOU need to have to be GOOD candidate?
Required Level of Education, Licenses, and/or Certificates
<ul><li>High school diploma or equivalent.
</li><li>Required Level of Experience
</li>1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail. 
<li>
</li></ul>Required Knowledge, Skills, and Abilities
<ul><li>Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook.
</li><li>Ability to work occasional overtime as needed.
</li><li>Excellent listening and communication skills.
</li><li>Superior customer service skills including the natural ability to provide empathy.
</li><li>Strong data entry/typing skills.
</li><li>Strong navigation skills and the ability to multi-task.
</li><li>Excellent attention to detail.
</li>Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions. 
<li>
</li></ul>What qualifications do YOU need to be a GREAT candidate?
Preferred Level of Experience
<ul><li>1+ years of job related customer service experience within the dental, vision or medical industry.
</li><li>Previous experience working in a virtual environment.
</li><li>Understanding of dental, vision and/or medical insurance terminology.</li></ul></div>

Customer Care Rep II - Virtual!

Prime Therapeutics

<div>At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.<h2 class="jobSectionHeader">
Job Posting Title</h2>
Provider Relations Analyst Sr - Remote<h2 class="jobSectionHeader">
Job Description</h2><div>
The Senior Provider Relations Analyst is responsible for contracting efforts and managing Prime&rsquo;s independent pharmacy networks. This position is responsible for the management of Prime&rsquo;s independent pharmacy network contracting activities, ensuring contracting initiatives are effective and completed in accordance with network management strategies. In addition, this position manages and maintains the Prime Provider Manual, issues resolution for escalated pharmacies inquiries through the Provider Relations email box.</div>
Responsibilities<ul><li>
Research and resolve pharmacy contract related inquires; evaluate network participation and distribute pharmacy contract documents; coordinate timely, accurate and complete submission of contract deliverables, and the electronic and physical tracking, storage and distribution of contract documents</li><li>
Ensure all contractual obligations adhere with company policies, regulatory compliance and legal requirements; engage with Legal and Network Management leadership as needed to ensure the language provided is accurate and concise</li><li>
Establish, develop, and maintain relationships with independent pharmacy providers</li><li>
Manage legal-to-legal correspondences between Prime and independent Pharmacy Providers escalating to Prime Legal Counsel as required</li><li>
Conduct root cause analysis, including but not limited to, investigating, monitoring, resolving and reporting for pharmacy contract and pricing analysis complaints issues</li><li>
Evaluate pharmacy inquiries to include but not limited to complaints, issues and/or grievances and collaborate with internal stakeholders, such as Network Management, Client Engagement, and Benefit Operation</li><li>
Manage and edit Prime&rsquo;s Provider Manual to ensure compliance and timely distribution, while contributing to process improvements that support cross-functional projects, regulatory changes, and client implementations</li><li>
Other duties as assigned</li></ul>
Minimum Qualifications<ul><li>
Bachelor's degree in Business or related area of study, or equivalent combination of education and/or relevant work experience; High school diploma or GED required</li><li>
5 years of work experience in a call center, customer service, operations, retail pharmacy, pharmacy technician, Pharmacy Benefit Management (PBM)</li></ul>
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications<ul><li>
Strong interpersonal communication skills including conflict resolution and listening</li><li>
Advanced ability to problem solve and interpret complex data</li><li>
Proficiency within Microsoft applications such as Outlook, Word and Excel</li><li>
Enhanced ability to coordinate multiple tasks and projects simultaneously under strict timelines</li><li>
Ability to work in fast-paced, collaborative team environment</li><li>
Enhanced ability to establish rapport and effectively influence at all levels within an organization</li></ul>
Preferred Qualifications<ul><li>
Experience analyzing state and federal regulations</li><li>
Experience working with RxClaim system or other claims processing experience</li><li>
Pharmacy Technician certification (CPhT) or equivalent pharmacy experience</li><li>
Experience with negotiating contracts</li><li>
Salesforce experience</li><li>
Experience reviewing and responding to questions related to contracts</li><li>
Familiarity with reviewing and managing contract redlines</li><li>
Experience supporting or coordinating the execution of contracts</li></ul>
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $66,000.00 - $106,000.00 based on experience and skills. 
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.</div>

Provider Relations Analyst Sr - Remote

RxHealing

RxHealing is expanding its medical sales team to support a diversified portfolio of compliant healthcare solutions, including Remote Patient Monitoring and regenerative medicine offerings, and related medical devices. This role operates in a highly regulated healthcare environment and focuses on provider education, relationship development, and compliant program adoption across multiple clinical settings.The primary entry focus for this position is Remote Patient Monitoring, with structured expansion into regenerative medicine solutions such as exosomes, and supporting medical devices after completion of required training and certifications. All offerings are introduced based on clinical appropriateness, provider interest, and strict compliance guidelines.This is not a retail or consumer sales role. Representatives work directly with physicians, clinics, pharmacies, and specialty practices and must adhere to CMS, Medicare, HIPAA, and internal compliance standards at all times.Scope of ServicesRemote Patient Monitoring programs that support chronic condition management and medication adherence through connected medical devices and clinical workflows. Cash pay regenerative medicine solutions, including exosome based therapies, presented strictly within approved educational and compliance boundaries.ResponsibilitiesDevelop and manage professional relationships with providers, pharmacies, and clinical staff. Educate healthcare partners on approved programs, devices, and workflows. Introduce RPM as the initial solution and support expansion into regenerative medicine, and devices when appropriate. Coordinate demonstrations, onboarding, and follow up with internal clinical and support teams. Conduct in person visits within the assigned territory as needed. Complete all required Lightspeed training modules and certifications. Follow all compliance, documentation, and communication standards. Represent RxRemoteCare and RxHealing with professionalism, integrity, and a patient first mindset.All outreach uses approved informational materials. Not all patients may qualify.QualificationsExperience in medical sales, healthcare sales, device sales, or provider relations preferred. Comfort working in a regulated, compliance driven healthcare environment. Strong communication, organization, and follow up skills. Self directed, resilient, and relationship focused. High ethical standards and sound decision making. Ability and willingness to travel locally within the assigned territory.Training and SupportStructured onboarding through an interactive Lightspeed experience. Mandatory completion of training and certifications prior to promoting additional services. Ongoing education, compliance guidance, and leadership support. Company provided tools to support compliant outreach and account management.CompensationIndependent contractor role with performance based compensation. No start up fees. No recruiting. No product inventory requirements.CompliancePrograms are HIPAA compliant and overseen by qualified health professionals. Representatives do not provide clinical care or access patient medical records. Materials are for informational use only. Not all patients may qualify.Job Type: ContractPay: $85,000.00 - $300,000.00 per yearBenefits:<ul><li>Flexible schedule</li></ul>Work Location: Remote

Medical Sales Representative, Remote Care and Regenerative Medicine Solutions

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