Provider Relations Representative Jobs
Provider Relations Representative jobs are open across healthcare, insurance, managed care, and government programs, at every level from entry-level coordinator to senior and manager, with specializations in credentialing, network development, and provider engagement. See the openings below and apply to the ones that match your experience.
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We are seeking a Provider Relations Account Executive to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Provider Relations Account Executive plays an essential role in fostering and maintaining strong partnerships between our healthcare organization and a diverse network of providers. The Provider Relations Account Executive position is responsible for ensuring seamless communication, addressing provider concerns, and facilitating contract negotiations to optimize service delivery and network growth. The Provider Relations Account Executive will work collaboratively with internal teams to align provider capabilities with organizational goals, enhancing member access and satisfaction. By proactively managing provider relationships, the Provider Relations Account Executive contributes to the overall efficiency and quality of healthcare services offered. Ultimately, the Provider Relations Account Executive drives the expansion and retention of a high-performing provider network that supports the organization's mission and strategic objectives.
Minimum Qualifications:
- Bachelor’s degree in Healthcare Administration, Business, or a related field.
- 3 years of experience in provider relations, account management, or a similar role within the healthcare industry.
- Strong knowledge of healthcare provider networks, contract negotiation, and regulatory compliance.
- Proficiency in Microsoft Office Suite and experience with healthcare management software.
- Relevant experience may substitute for educational requirement on a year-for-year basis.
Preferred Qualifications:
- Master’s degree in Healthcare Administration, Business, or a related discipline.
- Experience working with managed care organizations or health insurance providers.
- Familiarity with healthcare data analytics and performance measurement tools.
- Demonstrated success in managing complex provider networks and multi-stakeholder projects.
- Certification in healthcare management or provider relations (e.g., Certified Provider Relations Specialist).
Responsibilities:
- Develop and maintain strong collaborative relationships with providers through high-touch communication to ensure network adequacy and quality and other provider performance goals are met.
- Facilitate the development, negotiation, and execution of provider contracts, ensuring terms meet regulatory standards and organizational policies.
- Monitor provider performance metrics and work with providers to implement corrective action plans when necessary.
- Serve as the primary point of contact for all assigned providers, and as a link to various departments to address inquiries, resolve disputes, and maintain positive partnerships..
- Maintain accurate records of provider interactions and follow up on outstanding issues to ensure timely resolution.
- Collaborate with cross-functional teams including care management, compliance, and finance to support provider network initiatives and improve service delivery. opportunities for growth and expansion within existing provider accounts.
- Ensure high levels of provider satisfaction by providing exceptional service and support.
We are seeking a Provider Relations Account Executive to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Provider Relations Account Executive plays an essential role in fostering and maintaining strong partnerships between our healthcare organization and a diverse network of providers. The Provider Relations Account Executive position is responsible for ensuring seamless communication, addressing provider concerns, and facilitating contract negotiations to optimize service delivery and network growth. The Provider Relations Account Executive will work collaboratively with internal teams to align provider capabilities with organizational goals, enhancing member access and satisfaction. By proactively managing provider relationships, the Provider Relations Account Executive contributes to the overall efficiency and quality of healthcare services offered. Ultimately, the Provider Relations Account Executive drives the expansion and retention of a high-performing provider network that supports the organization's mission and strategic objectives.
Minimum Qualifications:
- Bachelor’s degree in Healthcare Administration, Business, or a related field.
- 3 years of experience in provider relations, account management, or a similar role within the healthcare industry.
- Strong knowledge of healthcare provider networks, contract negotiation, and regulatory compliance.
- Proficiency in Microsoft Office Suite and experience with healthcare management software.
- Relevant experience may substitute for educational requirement on a year-for-year basis.
Preferred Qualifications:
- Master’s degree in Healthcare Administration, Business, or a related discipline.
- Experience working with managed care organizations or health insurance providers.
- Familiarity with healthcare data analytics and performance measurement tools.
- Demonstrated success in managing complex provider networks and multi-stakeholder projects.
- Certification in healthcare management or provider relations (e.g., Certified Provider Relations Specialist).
Responsibilities:
- Develop and maintain strong collaborative relationships with providers through high-touch communication to ensure network adequacy and quality and other provider performance goals are met.
- Facilitate the development, negotiation, and execution of provider contracts, ensuring terms meet regulatory standards and organizational policies.
- Monitor provider performance metrics and work with providers to implement corrective action plans when necessary.
- Serve as the primary point of contact for all assigned providers, and as a link to various departments to address inquiries, resolve disputes, and maintain positive partnerships..
- Maintain accurate records of provider interactions and follow up on outstanding issues to ensure timely resolution.
- Collaborate with cross-functional teams including care management, compliance, and finance to support provider network initiatives and improve service delivery. opportunities for growth and expansion within existing provider accounts.
- Ensure high levels of provider satisfaction by providing exceptional service and support.
Provider Relations Representative Jobs by Experience Level
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Find JobsProvider Relations Representative Job Market
Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services
- Insurance
- Technology & Software
What Employers Look For
The qualifications that appear most often in provider relations representative jobs.
- Two or more years of experience in provider relations, credentialing, or healthcare contracting
- Proficiency with provider data management and credentialing platforms such as CAQH or PECOS
- Knowledge of managed care, Medicare, Medicaid, or commercial insurance plan structures
- Strong verbal and written communication skills for provider outreach and dispute resolution
- Associate or bachelor's degree in healthcare administration, business, or a related field
- Familiarity with contract terms, network adequacy standards, and provider appeals processes
Tips for Your Provider Relations Representative Job Search
Tailor your resume to credentialing workflows
Highlight experience with provider enrollment, credentialing databases, or contract management systems on your resume. Recruiters for these roles scan for familiarity with CAQH, PECOS, or similar platforms, so name the tools you have actually used.
Target listings by network type
Filter openings by payer type, such as commercial, Medicaid, or Medicare Advantage, because day-to-day workflows differ significantly. Matching your background to the right network type makes your application far more competitive than applying broadly.
Apply early to roles that fit
Migrate Mate lists provider relations representative openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Quantify your provider outreach results
Instead of listing job duties, show outcomes: how many providers you onboarded, disputes you resolved, or network gaps you closed. Hiring managers in this field respond to numbers that demonstrate relationship management at scale.
Prepare for scenario-based interview questions
Interviewers frequently ask how you have handled a provider threatening to leave a network or a credentialing dispute that stalled. Prepare two or three concrete examples that show your ability to de-escalate and reach resolution.
Negotiate using your provider portfolio scope
When discussing compensation, reference the size and complexity of the provider network you managed, including specialty mix and geographic reach. This context anchors your value more effectively than job title comparisons alone.
Provider Relations Representative Jobs: Frequently Asked Questions
Which companies are hiring the most provider relations representatives?
The companies hiring the most provider relations representatives right now include Independent Living Systems, The Emily Program, and Molina Healthcare, with the largest share of openings in Florida, California, and New York, based on current listings on Migrate Mate as of August 2026. Health plans, managed care organizations, and Medicaid managed care contractors consistently post the highest volume of these roles.
How many provider relations representative jobs are remote?
About 89% of provider relations representative openings are fully remote or hybrid as of August 2026, reflecting increased flexibility across the healthcare industry. Provider outreach, credentialing support, and dispute resolution roles tend to be the most remote-eligible, while positions involving in-person provider visits or local network development are more likely to require on-site presence.
How do you become a provider relations representative?
Start by building foundational knowledge in healthcare administration, insurance operations, or managed care through a degree program or entry-level work in a related role such as provider enrollment or member services. Gain hands-on experience with credentialing processes and provider data systems, then pursue roles that involve direct provider contact. Familiarity with payer structures and regulatory requirements strengthens your candidacy at every stage.
Can you get hired as a provider relations representative with little experience?
Yes, entry-level provider relations representative roles exist, particularly at health plans and third-party administrators that run structured training programs. Candidates with customer service, medical billing, or healthcare administrative backgrounds are frequently considered for these positions. Demonstrating knowledge of managed care terminology, showing comfort with database tools, and expressing genuine interest in provider partnerships can offset a shorter work history.
What does the provider relations representative interview process look like?
The process typically includes an initial phone screen with a recruiter focused on your healthcare background, followed by one or two interviews with a hiring manager and sometimes a panel from the network or contracting team. Expect behavioral questions about conflict resolution with providers, experience managing credentialing timelines, and scenarios involving network retention. Some employers add a brief written exercise or case study related to provider outreach or dispute handling.
Where can I find and apply to provider relations representative jobs?
You can find and apply to provider relations representative jobs on Migrate Mate, which lists current openings from across the United States. Search for roles that match your background in areas like credentialing, network development, or provider outreach, and apply directly to each listing that fits your experience and preferred location or work arrangement.
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