Provider Network Management Relations Executive
$53,768–$82,076 year
On-site · Albuquerque, New Mexico, United States
Job Summary
Provider Network Management Relations Executive to oversee network strategies and relationships with healthcare providers. Responsibilities include coordinating provider education on quality initiatives, developing and maintaining provider performance reporting, resolving provider-health plan issues, maintaining provider directory data integrity, conducting post-payment validation, and serving as the primary liaison between providers and the health plan. Role requires 50-65% field visits, collaboration with network contracting, and knowledge of reimbursement methodologies (capitation, DRG, RVU) alongside strong verbal/written communication, negotiation, and facilitation skills. Must have a High School Diploma or GED; full-time, weekday schedule at Presbyterian Healthcare Services in Albuquerque, NM.
Required Qualifications
- Three years experience in provider relations, provider contracting, claims processing, or customer service in a healthcare organization.
Additional Requirements
- AA/EOE/VET/DISABLED
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