Provider Relations Representative

Nm - Albuquerquemid

Other

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Quick Summary

Requirements Summary

Bachelor’s degree and 3 years of work experience in managed care, or a minimum of 5 years’ work experience in a managed care environment.

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At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for enhancing relationships with facility and physician providers and serving as a liaison through education, training, claims assistance, issue resolution, and ongoing provider service. The role supports provider understanding of policies, procedures, and reimbursement processes while fostering positive provider relationships and satisfaction.

Requirements

~2 min read

Bachelor’s degree and 3 years of work experience in managed care, or a minimum of 5 years’ work experience in a managed care environment.
Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
Effective interpersonal, analytical, presentation and communication skills.
Knowledge of the health care industry.
Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
Knowledge of contracts, applications, and products.
Understanding of provider reimbursement methods.
Working knowledge of claims processing systems.
Effective organizational and planning skills.
Analytical skills.
Ability to take initiative and work independently.
Demonstrated ability to meet deadlines and work well under pressure.
Clear and concise interpersonal, verbal and written communication skills.
Collaboration skills resulting in business/process improvements/changes.
PC experience and skills to include Word, Excel, PowerPoint, etc.
Facilitation, presentation and analytical skills.

Experience supporting provider relationships within a managed care, health plan, hospital, or physician practice environment.
Knowledge of provider office workflows, practice operations, and healthcare administrative processes.
Strong customer service mindset with a focus on provider satisfaction and relationship management.
Ability to identify trends and recurring provider concerns to support operational improvements.
Demonstrated ability to prioritize multiple assignments while maintaining accuracy and attention to detail.

This is a Flex position that requires 3 days in office and 2 days work from home.

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

$55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location.