H-1B Visa Provider Relations Representative Jobs
Provider Relations Representative roles sit at the intersection of healthcare operations and network management, making them strong candidates for H-1B visa specialty occupation classification when the position requires a bachelor's degree in healthcare administration, business, or a related field. Employers in managed care, hospital systems, and insurance networks regularly sponsor H-1B visas for this role.
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Get Access To All JobsINTRODUCTION
UPMC Community Care Behavioral Health is seeking a full-time Provider Relations Representative to join the Network Management team. This hybrid position is based in downtown Pittsburgh’s U.S. Steel Tower and includes three in-office days per week, with occasional travel to provider sites. The ideal candidate will bring prior behavioral health experience and a strong commitment to supporting high quality care across the provider network.
ROLE AND RESPONSIBILITIES
In this role, the Provider Relations Representative will build and maintain strong working relationships with external providers, serving as the primary point of contact for an assigned caseload and offering support to additional caseloads as needed. The representative will ensure providers are well informed about Community Care’s policies, procedures, credentialing requirements, contracting processes, and claims and authorization functions. They will also demonstrate a solid understanding of differences among commercial, Medical Assistance, and other product lines, with attention to how these variations affect provider obligations.
Responsibilities:
- Assure that providers meet the clinical needs of enrolled consumers while continuing to comply with service delivery standards.
- Share responsibilities with other department personnel for answering the provider line.
- Establish excellent working relationships with a defined panel of providers.
- Work with the Director, Provider Relations and other staff as appropriate to develop the provider manuals and handbooks; this process will involve provider input as well as advice from appropriately designated advisory groups.
- Develop and implement an Action Plan in response to each provider service call.
- Participate in development and delivery of provider orientation and for follow-up as needed with assigned group.
- Work with colleagues on development of provider newsletter and other educational materials.
- Assure that assigned providers have current copies of all relevant educational materials, including the billing handbook and provider manual; is responsible for accurate interpretation of materials to providers in a consistent fashion and for identifying and proposing solutions to problems as they arise.
- Work as member of the Provider Relations staff, ensure that corrective action plans are implemented and result in complete problem resolution.
- Responsive to deadlines; complete assignments within deadlines at least 95% of the time.
- Meet or exceed specified goals for the number of provider service meetings on a quarterly basis.
- Balance time and effort spent on external provider servicing with in-office responsibilities.
- Coordinate service schedule with other Service Reps to ensure adequate and consistent phone coverage.
- Implement use of quality indicators for use within the network, including work with providers as necessary to assure full understanding and compliance.
- Manage supplemental service enrollment process for his/her designated panel of providers.
- Understand and communicates the details of the authorization process and Community Care's procedures for delivering the authorizations to providers.
- Valid PA drivers license and reliable car.
BASIC QUALIFICATIONS
- B.A or B.S. degree in a healthcare, human services or related field.
- 2 years of experience working in a complex organizational environment.
- 2 years of experience in healthcare or managed care environment.
PREFERRED QUALIFICATIONS
- Experience as a provider of behavioral health services and/or knowledge of behavioral health provider system strongly preferred.
- Excellent written and oral communication skills.
- Must clearly and consistently articulate standards of care and specifics of the various provider agreements.
- Independent problem-solving skills, including the ability to address issues in a timely and accurate manner.
- Knowledge of public and private delivery systems in behavioral health care.
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran
INTRODUCTION
UPMC Community Care Behavioral Health is seeking a full-time Provider Relations Representative to join the Network Management team. This hybrid position is based in downtown Pittsburgh’s U.S. Steel Tower and includes three in-office days per week, with occasional travel to provider sites. The ideal candidate will bring prior behavioral health experience and a strong commitment to supporting high quality care across the provider network.
ROLE AND RESPONSIBILITIES
In this role, the Provider Relations Representative will build and maintain strong working relationships with external providers, serving as the primary point of contact for an assigned caseload and offering support to additional caseloads as needed. The representative will ensure providers are well informed about Community Care’s policies, procedures, credentialing requirements, contracting processes, and claims and authorization functions. They will also demonstrate a solid understanding of differences among commercial, Medical Assistance, and other product lines, with attention to how these variations affect provider obligations.
Responsibilities:
- Assure that providers meet the clinical needs of enrolled consumers while continuing to comply with service delivery standards.
- Share responsibilities with other department personnel for answering the provider line.
- Establish excellent working relationships with a defined panel of providers.
- Work with the Director, Provider Relations and other staff as appropriate to develop the provider manuals and handbooks; this process will involve provider input as well as advice from appropriately designated advisory groups.
- Develop and implement an Action Plan in response to each provider service call.
- Participate in development and delivery of provider orientation and for follow-up as needed with assigned group.
- Work with colleagues on development of provider newsletter and other educational materials.
- Assure that assigned providers have current copies of all relevant educational materials, including the billing handbook and provider manual; is responsible for accurate interpretation of materials to providers in a consistent fashion and for identifying and proposing solutions to problems as they arise.
- Work as member of the Provider Relations staff, ensure that corrective action plans are implemented and result in complete problem resolution.
- Responsive to deadlines; complete assignments within deadlines at least 95% of the time.
- Meet or exceed specified goals for the number of provider service meetings on a quarterly basis.
- Balance time and effort spent on external provider servicing with in-office responsibilities.
- Coordinate service schedule with other Service Reps to ensure adequate and consistent phone coverage.
- Implement use of quality indicators for use within the network, including work with providers as necessary to assure full understanding and compliance.
- Manage supplemental service enrollment process for his/her designated panel of providers.
- Understand and communicates the details of the authorization process and Community Care's procedures for delivering the authorizations to providers.
- Valid PA drivers license and reliable car.
BASIC QUALIFICATIONS
- B.A or B.S. degree in a healthcare, human services or related field.
- 2 years of experience working in a complex organizational environment.
- 2 years of experience in healthcare or managed care environment.
PREFERRED QUALIFICATIONS
- Experience as a provider of behavioral health services and/or knowledge of behavioral health provider system strongly preferred.
- Excellent written and oral communication skills.
- Must clearly and consistently articulate standards of care and specifics of the various provider agreements.
- Independent problem-solving skills, including the ability to address issues in a timely and accurate manner.
- Knowledge of public and private delivery systems in behavioral health care.
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran
See all 32+ H-1B Visa Provider Relations Representative Jobs
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Get Access To All JobsTips for Finding H-1B Visa Sponsorship in Provider Relations Representative
Confirm your role meets specialty occupation
Pull the O*NET profile for Provider Relations Representative to document the degree requirements tied to the occupation. USCIS requires your specific position to demand at least a bachelor's degree in a directly related field, so generic job duties won't hold up without that documentation.
Target managed care organizations over staffing firms
Health plans, regional HMOs, and hospital network management divisions file LCAs directly as cap-subject employers. Staffing agency placements add H-1B dependency complexity, which tightens prevailing wage obligations and can slow your petition timeline significantly.
Look up prevailing wages before negotiating your offer
Use the OFLC Wage Search to check the Level I through Level IV wage tiers for your metro area before your offer letter arrives. Employers must pay at least the prevailing wage on your certified LCA, so knowing the floor helps you evaluate whether an offer is compliant.
Filter for verified H-1B sponsors on Migrate Mate
Search Provider Relations Representative roles on Migrate Mate to see employers with confirmed H-1B LCA filing history in healthcare network management. That history signals both sponsorship willingness and familiarity with the DOL certification process for your occupation.
Clarify H-1B transfer timing before your 60-day window closes
If you're leaving an H-1B job, a new employer can file a transfer petition and you can start working upon receipt, but only if you've maintained valid status. Don't wait until your last day to confirm your prospective employer is ready to file.
Request employer E-Verify enrollment confirmation early
STEM OPT employers must be E-Verify enrolled, and many healthcare networks already are, but verify it before you accept an offer if you're bridging from OPT. An employer that isn't enrolled can't legally employ you on STEM OPT while your H-1B petition is pending.
H-1B Visa Provider Relations Representative: Frequently Asked Questions
Does a Provider Relations Representative role qualify as a specialty occupation for H-1B purposes?
It can qualify, but the employer must demonstrate that the specific position requires at least a bachelor's degree in a directly related field, such as healthcare administration, business administration, or a clinical discipline. Roles at larger health plans and managed care organizations tend to have clearer degree requirements tied to the job duties, which strengthens the specialty occupation argument. Generic or entry-level coordinator titles with no degree requirement in the job posting are harder to support.
Which types of employers sponsor H-1B visas for this role?
Managed care organizations, regional health plans, hospital networks, and large physician management groups are the most active sponsors for Provider Relations Representative positions. These employers deal with credentialing, contract negotiation, and network compliance at scale, which creates sustained demand for the role. You can browse employers with verified H-1B LCA filing history for this occupation on Migrate Mate before targeting your applications.
How does the H-1B prevailing wage apply to Provider Relations Representative positions?
Your employer must certify through a Labor Condition Application that they'll pay you at least the prevailing wage for your occupation and work location before USCIS will approve the petition. The DOL sets four wage levels based on experience and supervisory responsibilities. Use the OFLC Wage Search to look up the current wage tiers for your metro area so you can evaluate any offer against the legal minimum before signing.
Can I transfer my H-1B to a new employer if I change provider relations jobs?
Yes, H-1B portability lets you move to a new employer once they file a transfer petition with USCIS and you receive the receipt notice, as long as your previous H-1B was approved and you've maintained valid status. You can start the new job upon receipt without waiting for approval. The key is timing: your new employer needs to have the petition ready to file on or before your last day with the previous employer.
Does working remotely affect my H-1B status as a Provider Relations Representative?
Remote work creates a worksite location issue under H-1B rules. Your employer's LCA must cover the geographic area where you actually work, not just their headquarters. If you'll be working from home in a different metro area than the one listed on your LCA, your employer may need to file an amended petition with USCIS and a new LCA for your home location. Confirm this with your employer before agreeing to any remote arrangement.