Provider Resources Inc Jobs Hiring Now

About PRI LLC

Provider Resources Inc. (PRI LLC) is a federally certified Independent Dispute Resolution Entity (IDRE) and Independent Review Organization (IRO) operating under the No Surprises Act. We process payment disputes that directly protect patients from unexpected medical bills — and we do it at scale, with precision, in one of the most scrutinized regulatory environments in healthcare. We are a growth-stage company of approximately 200 people, backed by a search fund, and building the systems and team that will define PRI LLC for the next decade.

The Role

We are looking for a Stakeholder Engagement Manager — PRI LLC's dedicated expert for external relationship management within the IDR process. This is a senior individual contributor role. The title reflects account ownership and subject matter expertise, not people management.

You will be PRI LLC's primary point of contact for health plans and providers on IDRE disputes, escalations, and process questions. You will interpret NSA rules and CMS guidance in real time, conduct audit-level case file reviews in our system of record, and build the communication standards the function will run on. You will represent PRI LLC externally — at CMS events, industry meetings, and educational forums — as someone who knows this process at a level most people in the industry do not.

What You Will Do

• Serve as the primary contact for health plans and providers on all IDRE disputes, escalations, and process questions
• Interpret NSA rules and CMS guidance in real time — no committee needed for routine questions
• Conduct auditlevel case file reviews in GlideOps to answer stakeholder questions with specificity and documentation
• Manage escalated disputes from initiation to resolution, coordinating with QA, compliance, and operations
• Build and own PRI LLC's external communication standards — templates, turnaround expectations, escalation protocols
• Capture and deliver structured stakeholder feedback to QA and compliance leadership on a regular cadence
• Track CMS guidance and interim final rules; communicate relevant changes to internal stakeholders proactively
• Represent PRI LLC at external meetings, webinars, and educational events

What We Are Looking For

• JD or LLM preferred; significant NSA/IDRE operational, regulatory, or arbitration experience considered in lieu
• Arbitration experience — IDR arbitration ideal; AAA, JAMS, AHLA, or commercial arbitration background considered
• Deep familiarity with the No Surprises Act IDR process from an operational or regulatory perspective
• Experience managing complex external relationships with accountability for resolution outcomes, not just response volume
• Auditor instinct: you move toward case files and complexity, not away from them
• Ability to make decisions independently and move fast without committee input
• Prior IDRE, IDRE, IRO, managed care, utilization review, or healthcare regulatory environment experience

Why PRI LLC

• Meaningful work — we process disputes that directly protect patients from unexpected medical bills under federal law
• Growth stage — we are building the systems, processes, and team that will define PRI LLC for the next decade
• Skills framework — every role at PRI LLC has a defined skills ontology with clear growth paths and Udemy Business development pathways
• Visible impact — this is not a support function; it is a role with direct accountability for how PRI LLC is perceived and trusted by health plans and providers
• Direct leadership access — small enough that your work reaches the executive team; structured enough that decisions get made

PRI LLC is an equal opportunity employer. We evaluate candidates on demonstrated skills and capability.

About PROVIDER RESOURCES INC

Join Provider Resources (PRI) and Make an Impact in Healthcare! At PRI, we’re passionate about driving integrity and advancing quality across the healthcare system. As a trusted leader in the industry, we’re tackling some of healthcare’s biggest challenges—improving compliance, advancing health equity, and enhancing quality and clinical outcomes while helping organizations improve care delivery and create meaningful change. We believe that people are at the heart of healthcare, and focus on scalable, person-centered strategies that prioritize clinical excellence and evidence-based practices. Our work supports a broad network of stakeholders, including providers, patients, caregivers, payers, and regulators. We strive to enhance experiences, improve outcomes, and foster a healthier future for all. If you’re looking to be part of a forward-thinking team that makes a difference, PRI is the place for you!