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

* Bachelor's degree required.

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

* Strong facilitation and relationship management skills.

* Excellent communication and presentation abilities.