OPT Provider Relations Representative Jobs
Provider Relations Representative jobs involve managing relationships between healthcare organizations and their provider networks, making strong communication and analytical skills essential. Many employers in managed care, insurance, and hospital systems hire OPT students for these roles, which typically require a degree in healthcare administration, business, or a related field.
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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
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Get Access To All JobsTips for Finding OPT Sponsorship in Provider Relations Representative
Target managed care and insurance employers
Health insurance companies, Medicaid managed care organizations, and hospital systems hire Provider Relations Representatives regularly. These large employers are more likely to have HR infrastructure familiar with OPT work authorization and STEM OPT extensions for qualifying degrees.
Highlight your degree field on your resume
Provider Relations roles often qualify under healthcare administration, public health, or business degrees. Make your degree field and its relevance to the role explicit on your resume so hiring managers can quickly assess your OPT eligibility without guessing.
Address your OPT timeline upfront
Know your OPT end date and whether you qualify for a 24-month STEM extension before interviews. Employers appreciate candidates who can clearly explain their authorization period and what the next steps look like, rather than leaving it vague.
Frame language skills as a differentiator
Provider relations work often involves communicating with diverse provider networks. If you speak a language other than English fluently, highlight this explicitly. Bilingual candidates are often prioritized for roles covering multilingual provider communities.
Prepare to explain your work authorization confidently
Many hiring managers in healthcare are unfamiliar with OPT. Practice a clear two-sentence explanation covering what OPT is, how long your authorization lasts, and whether STEM extension applies. Confidence here reduces employer hesitation significantly.
Pursue roles with structured onboarding programs
Larger healthcare organizations with formal onboarding or rotational programs tend to have more experience hiring international candidates on OPT. These structured environments also give you better documentation of your role scope, which strengthens future visa sponsorship cases.
Provider Relations Representative OPT: Frequently Asked Questions
Can I work as a Provider Relations Representative on OPT?
Yes, if the role is directly related to your degree field. Provider Relations Representative positions typically qualify for OPT students with degrees in healthcare administration, public health, business administration, or a related field. The job duties must connect to your area of study, so document that connection clearly in case your employer or USCIS requests verification.
Do Provider Relations Representative jobs qualify for the STEM OPT extension?
They can, but it depends on your degree. If your degree is in a STEM-designated field such as health informatics, data analytics, or information systems, and your Provider Relations role involves applying technical skills from that field, you may qualify for the 24-month STEM OPT extension. Healthcare administration and business degrees are generally not STEM-designated, so check your program's Classification of Instructional Programs code with your DSO.
What types of employers hire Provider Relations Representatives and are familiar with OPT?
Managed care organizations, health insurance companies, hospital networks, and third-party administrators are the most common employers for this role. Larger organizations in these categories tend to have dedicated HR and legal teams with prior experience hiring OPT candidates. You can browse open Provider Relations Representative positions on Migrate Mate, which filters specifically for employers open to OPT sponsorship.
How do I explain OPT to a healthcare employer who isn't familiar with it?
Keep it concise and focus on what matters to them: you're legally authorized to work in the United States for a defined period without any action required from the employer. Explain your current end date, whether you're eligible for a STEM extension, and that no sponsorship costs apply during OPT. Employers worry most about timing and cost, so address both directly.
Will a Provider Relations Representative job support a future H-1B or other visa sponsorship?
It can, depending on the employer and how the role is classified. Provider Relations positions that require a bachelor's degree in a specific field can qualify as specialty occupations under H-1B visa rules. Your chances improve significantly with larger employers who have sponsored H-1B visas before. During the interview process, ask whether the organization has a history of sponsoring employment-based visas for employees transitioning off OPT.