Provider Relations Representative Jobs for OPT Students
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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Supervise daily operations and provide leadership, support, and direction to assigned Provider Relations Representative staff. Ensure the highest level of customer service is a priority of PR staff. Monitor department goals and meet deadlines. Recruit and retain Provider network.
Responsibilities:
- Supervise daily operations of assigned PR Representatives.
- Provide leadership, direction, support, and daily supervision to staff.
- Promote professionalism, positive attitudes, teamwork, and fun in the workplace.
- Conduct weekly staff meetings.
- Provide weekly and/or monthly performance feedback to PR Representative staff.
- Conduct annual performance evaluations.
- Provide staff development, monitor staff performance, and provide counseling.
- Monitor REP visit logs, score cards, department goals, and ensure compliance.
- Interview and participate in selection of PR Representative staff.
- Resolve provider inquiries and problems.
- Assist with resolution of provider expressions of dissatisfaction, appeals, and grievances.
- Develop provider training materials in collaboration with SR Manager of Network Education and Credentialing.
- Supervise provider survey activities for DHCS, NCQA, and other Regulatory agencies. Ensure timelines are met, develop corrective action plans.
- Attend early morning and late evening provider/Partnership meetings.
- Coordinate new provider recruitment and contracting activities with Contracts staff as needed.
- Participate in special projects and assignments, ensure deadlines are met.
- Coordinate and monitor provider network trainings.
- Ensure PR Representatives meet provider visit goals, monitor issues identified during visits, and develop action plans with PR Representatives to address problems.
- Participate in DHCS annual audits as assigned.
- Assist with documentation to meet NCQA requirements.
- Active member of the Partnership CERT team.
- Participate in Partnership Team and Dept. goals.
- Ensure daily operations and servicing goals are met if REP staffing issues occur.
- Facilitate the scheduling of NR/SR combined REP meetings.
- If applicable, retain the day-to-day servicing of the assigned county provider network.
SECONDARY DUTIES AND RESPONSIBILITIES:
Back up to Director or Senior Provider Relations Representative Manager as directed.
QUALIFICATIONS
Education and Experience
Bachelor’s degree in Healthcare, Marketing, Public Relations, or related field; minimum three (3) years in healthcare, marketing, or public relations experience in a managed care environment preferred; or equivalent combination of education and experience. Two (2) years of experience as a Provider Relations Representative.
Special Skills, Licenses and Certifications
Working knowledge of business software applications. Knowledge of managed care concepts, policies, and procedures. Ability to disseminate MediCal policies and procedures. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business.
Performance Based Competencies
Excellent oral and written communication skills. Excellent organization skills with the ability to prioritize assignments, maintain accurate records, and meet deadlines. Ability to use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.
Work Environment And Physical Demands
Ability to use a computer keyboard. More than 30% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying size, weighing up to 35 lbs.
All HealthPlan employees are expected to:
- Provide the highest possible level of service to clients;
- Promote teamwork and cooperative effort among employees;
- Maintain safe practices; and
- Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.
HIRING RANGE:
$93,690.86 - $117,113.58
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
Overview:
Supervise daily operations and provide leadership, support, and direction to assigned Provider Relations Representative staff. Ensure the highest level of customer service is a priority of PR staff. Monitor department goals and meet deadlines. Recruit and retain Provider network.
Responsibilities:
- Supervise daily operations of assigned PR Representatives.
- Provide leadership, direction, support, and daily supervision to staff.
- Promote professionalism, positive attitudes, teamwork, and fun in the workplace.
- Conduct weekly staff meetings.
- Provide weekly and/or monthly performance feedback to PR Representative staff.
- Conduct annual performance evaluations.
- Provide staff development, monitor staff performance, and provide counseling.
- Monitor REP visit logs, score cards, department goals, and ensure compliance.
- Interview and participate in selection of PR Representative staff.
- Resolve provider inquiries and problems.
- Assist with resolution of provider expressions of dissatisfaction, appeals, and grievances.
- Develop provider training materials in collaboration with SR Manager of Network Education and Credentialing.
- Supervise provider survey activities for DHCS, NCQA, and other Regulatory agencies. Ensure timelines are met, develop corrective action plans.
- Attend early morning and late evening provider/Partnership meetings.
- Coordinate new provider recruitment and contracting activities with Contracts staff as needed.
- Participate in special projects and assignments, ensure deadlines are met.
- Coordinate and monitor provider network trainings.
- Ensure PR Representatives meet provider visit goals, monitor issues identified during visits, and develop action plans with PR Representatives to address problems.
- Participate in DHCS annual audits as assigned.
- Assist with documentation to meet NCQA requirements.
- Active member of the Partnership CERT team.
- Participate in Partnership Team and Dept. goals.
- Ensure daily operations and servicing goals are met if REP staffing issues occur.
- Facilitate the scheduling of NR/SR combined REP meetings.
- If applicable, retain the day-to-day servicing of the assigned county provider network.
SECONDARY DUTIES AND RESPONSIBILITIES:
Back up to Director or Senior Provider Relations Representative Manager as directed.
QUALIFICATIONS
Education and Experience
Bachelor’s degree in Healthcare, Marketing, Public Relations, or related field; minimum three (3) years in healthcare, marketing, or public relations experience in a managed care environment preferred; or equivalent combination of education and experience. Two (2) years of experience as a Provider Relations Representative.
Special Skills, Licenses and Certifications
Working knowledge of business software applications. Knowledge of managed care concepts, policies, and procedures. Ability to disseminate MediCal policies and procedures. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business.
Performance Based Competencies
Excellent oral and written communication skills. Excellent organization skills with the ability to prioritize assignments, maintain accurate records, and meet deadlines. Ability to use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.
Work Environment And Physical Demands
Ability to use a computer keyboard. More than 30% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying size, weighing up to 35 lbs.
All HealthPlan employees are expected to:
- Provide the highest possible level of service to clients;
- Promote teamwork and cooperative effort among employees;
- Maintain safe practices; and
- Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.
HIRING RANGE:
$93,690.86 - $117,113.58
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
How to Get Visa 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.
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Get Access To All JobsFrequently 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 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.
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