Provider Relations Representative

The Provider Relations Representative plays a key role in managing and developing transportation provider networks within a designated area. This role requires a mix of strong interpersonal skills, analytical capabilities, and expertise in transportation services.
Position Overview: The Provider Relations Representative will oversee the development and maintenance of transportation provider networks, ensuring effective communication and ongoing relationships with providers. They will be responsible for contracting, rate negotiation, compliance with credentialing policies, and the execution of special projects. The role also requires leadership in quarterly provider meetings, addressing network deficiencies, and implementing corrective actions as necessary.
Key Responsibilities:
Provider Network Management - Develop and maintain a healthy provider network for the assigned area. - Oversee the onboarding process of transportation providers, ensuring compliance with contracting, credentialing, and insurance requirements. - Execute network development plans to prevent deficiencies and ensure cost management. - Ensure performance criteria of transportation providers are met and exceeded. - Manage provider relations, including negotiating rates, resolving issues, and implementing corrective actions when necessary. - Take charge of network digitization and act as the subject matter expert for platform initiatives. - Lead and manage quarterly provider meetings, ensuring smooth communication and relationship-building.
Client Relations - Build and sustain strong relationships with transportation providers and related external agencies. - Address provider complaints and resolve issues related to service quality and performance.
Reporting and Data Collection - Provide weekly reports on network health, unit cost, rate exceptions, network development, and platform utilization. - Collect, analyze, and report data related to provider performance and network health.
Skills and Abilities - Strong analytical and problem-solving skills. - Excellent communication skills (both oral and written). - Ability to work independently or as part of a team. - Skilled in negotiation and contract management. - Familiarity with Medicare/Medicaid and Non-Emergency Medical Transportation. - Proficiency in Microsoft Office (Word, Excel, Outlook) and ability to learn proprietary software systems. - Ability to manage conflict, deliver quality improvement, and demonstrate superior time management.
Education and Experience –
Education: Bachelor's degree in Business, Logistics, Marketing, or a related field (preferred). - Experience: - 5+ years in transportation services and provider network development. - 2 years of staff supervisory experience. - Experience in contract negotiation and budget management.
Driving Requirements - Valid driver’s license and the ability to pass a DMV record check. - Compliant driving record, use of a hands-free mobile phone while driving.
Physical Demands - Ability to sit and work at a computer, use a phone, and occasionally lift up to 10 pounds. - Ability to perform repetitive tasks like data entry.
Work Environment - The role involves 60% office/home setting work and 40% travel, including attending provider meetings, conducting observations, and performing inspections.
Additional Expectations - The job requires adaptability, the ability to manage multiple tasks, and an eagerness to address issues proactively. - The position may involve other duties as needed. This job description provides a comprehensive look at the responsibilities and qualifications expected of a Provider Relations Representative, focusing on network development, provider relations, compliance, and reporting.