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
Manages and maintains relationships with an assigned portfolio of contracted and prospective providers, serving as a primary liaison between VNS Health Plans and provider organizations. Responsible for supporting provider engagement, operational performance, contract implementation, education, and resolution of provider-related issues. Works collaboratively with internal departments and provider leadership to address complex operational, contractual, claims, compliance, quality, and service-related matters. Monitors provider needs and performance, identifies trends and opportunities for improvement, and coordinates appropriate follow-up and resolution. The role requires general direction, strong relationship management skills, knowledge of managed care operations and government-sponsored programs, and the ability to effectively navigate and coordinate across multiple internal and external stakeholders.
What You Will Do
- Manages an assigned portfolio of provider relationships, serving as a primary point of contact for provider leadership and key stakeholders and maintaining ongoing engagement to support strong provider relationships and network performance.
- Supports the implementation and ongoing administration of provider agreements, including provider education, contract requirements, operational expectations, demographic updates, renewals, and coordination with Contracting and Network teams.
- Educates providers on VNS Health Plans policies, procedures, contractual requirements, government program requirements, eligibility, operational processes, and other health plan initiatives.
- Monitors provider performance, identifies trends, gaps, discrepancies, and opportunities for improvement, and collaborates with internal and external stakeholders to develop and implement appropriate resolutions.
- Coordinates resolution of complex provider issues involving claims, billing, configuration, credentialing, contracting, quality, compliance, utilization, member service, and other operational matters, while maintaining ownership of the provider relationship through resolution.
- Serves as a liaison between providers and internal departments, facilitating communication and coordinating cross-functional efforts to address provider concerns and ensure timely follow-up.
- Leads and/or participates in provider meetings, business reviews, education sessions, site visits, and other provider engagement activities; prepares relevant materials and communicates organizational priorities and expectations.
- Coordinates provider-related initiatives and special projects, including implementation of new programs, regulatory requirements, operational changes, and other health plan initiatives impacting the provider network.
- Reviews provider data, reports, and other available information to identify discrepancies, trends, and potential areas of risk and escalating issues to the appropriate internal stakeholders.
- Partners with Compliance and other internal departments support Department of Health, regulatory, contractual, and internal audits and assist with provider follow-up and corrective actions as appropriate.
- Maintains accurate and timely documentation of provider interactions, activities, issues, and follow-up within designated systems and tools.
- Provides feedback to internal stakeholders regarding provider concerns, operational barriers, recurring issues, and opportunities to improve provider processes and the overall provider experience.
- Maintains current knowledge of VNS Health Plans products, provider network operations, applicable Medicare and Medicaid requirements, regulatory expectations, and organizational policies and procedures.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched 401k retirement saving program
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement and CEU credits
QUALIFICATIONS
Licenses and Certifications:
Drivers license required
Education:
Bachelor's Degree or equivalent related work experience and relevant professional experience, preferably in healthcare, business, public health, health services, or a related field required
Work Experience:
Minimum three years of experience in provider relations, account management, managed care, healthcare operations, network management, contracting, or a related healthcare field required. Working knowledge of government-sponsored healthcare programs, including Medicare and Medicaid, and their impact on provider operations, reimbursement, eligibility, and regulatory requirements preferred. Prior experience in Provider Relations, Provider Network Management, Account Management, Contracting, or a related healthcare function preferred.
Pay Range
USD $37.32 - USD $46.66 /Hr.
About us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
INTRODUCTION
Manages and maintains relationships with an assigned portfolio of contracted and prospective providers, serving as a primary liaison between VNS Health Plans and provider organizations. Responsible for supporting provider engagement, operational performance, contract implementation, education, and resolution of provider-related issues. Works collaboratively with internal departments and provider leadership to address complex operational, contractual, claims, compliance, quality, and service-related matters. Monitors provider needs and performance, identifies trends and opportunities for improvement, and coordinates appropriate follow-up and resolution. The role requires general direction, strong relationship management skills, knowledge of managed care operations and government-sponsored programs, and the ability to effectively navigate and coordinate across multiple internal and external stakeholders.
What You Will Do
- Manages an assigned portfolio of provider relationships, serving as a primary point of contact for provider leadership and key stakeholders and maintaining ongoing engagement to support strong provider relationships and network performance.
- Supports the implementation and ongoing administration of provider agreements, including provider education, contract requirements, operational expectations, demographic updates, renewals, and coordination with Contracting and Network teams.
- Educates providers on VNS Health Plans policies, procedures, contractual requirements, government program requirements, eligibility, operational processes, and other health plan initiatives.
- Monitors provider performance, identifies trends, gaps, discrepancies, and opportunities for improvement, and collaborates with internal and external stakeholders to develop and implement appropriate resolutions.
- Coordinates resolution of complex provider issues involving claims, billing, configuration, credentialing, contracting, quality, compliance, utilization, member service, and other operational matters, while maintaining ownership of the provider relationship through resolution.
- Serves as a liaison between providers and internal departments, facilitating communication and coordinating cross-functional efforts to address provider concerns and ensure timely follow-up.
- Leads and/or participates in provider meetings, business reviews, education sessions, site visits, and other provider engagement activities; prepares relevant materials and communicates organizational priorities and expectations.
- Coordinates provider-related initiatives and special projects, including implementation of new programs, regulatory requirements, operational changes, and other health plan initiatives impacting the provider network.
- Reviews provider data, reports, and other available information to identify discrepancies, trends, and potential areas of risk and escalating issues to the appropriate internal stakeholders.
- Partners with Compliance and other internal departments support Department of Health, regulatory, contractual, and internal audits and assist with provider follow-up and corrective actions as appropriate.
- Maintains accurate and timely documentation of provider interactions, activities, issues, and follow-up within designated systems and tools.
- Provides feedback to internal stakeholders regarding provider concerns, operational barriers, recurring issues, and opportunities to improve provider processes and the overall provider experience.
- Maintains current knowledge of VNS Health Plans products, provider network operations, applicable Medicare and Medicaid requirements, regulatory expectations, and organizational policies and procedures.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched 401k retirement saving program
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement and CEU credits
QUALIFICATIONS
Licenses and Certifications:
Drivers license required
Education:
Bachelor's Degree or equivalent related work experience and relevant professional experience, preferably in healthcare, business, public health, health services, or a related field required
Work Experience:
Minimum three years of experience in provider relations, account management, managed care, healthcare operations, network management, contracting, or a related healthcare field required. Working knowledge of government-sponsored healthcare programs, including Medicare and Medicaid, and their impact on provider operations, reimbursement, eligibility, and regulatory requirements preferred. Prior experience in Provider Relations, Provider Network Management, Account Management, Contracting, or a related healthcare function preferred.
Pay Range
USD $37.32 - USD $46.66 /Hr.
About us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
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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.