Remote Provider Relations Representative Jobs
Remote provider relations representative jobs are open across the U.S. in healthcare, managed care, and insurance, at remote-first payers, third-party administrators, and health tech companies hiring for everything from entry-level coordinators to senior relationship managers. Employers hiring remotely right now include Molina Healthcare, The Emily Program, and Key Family of Companies. See the openings below and apply to the ones that match your experience.
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JOB SUMMARY
Provides senior level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. 20% of travel is expected.
ESSENTIAL JOB DUTIES
- Successfully engages the plan's highest priority, high-volume and strategic complex community providers to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
- Serves as the primary point of contact between Molina health plan and the complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
- Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
- Resolves complex provider issues that may cross departmental lines and involve senior leadership.
- Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
- Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
- Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
- Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
- Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
- Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
- Serves as a subject matter expert for the provider relations function.
- Provides training and support to new and existing provider relations team members.
- Role requires 80%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).
REQUIRED QUALIFICATIONS
- At least 3 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
- Understanding of the health care delivery system, including government-sponsored health plans.
- Understanding of various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for-service (FFS), capitation and various forms of risk, ASO, etc.
- Experience delivering training and facilitating educational presentations.
- Organizational skills and attention to detail.
- Ability to manage multiple tasks and deadlines effectively.
- Interpersonal skills, including ability to interface with providers and medical office staff.
- Ability to work in a cross-functional highly matrixed organization.
- Effective verbal and written communication skills.
- Microsoft Office suite and applicable software programs proficiency.
PREFERRED QUALIFICATIONS
- Experience in provider services, operations, and/or contract negotiations in a Medicaid, Medicare, and/or Marketplace managed health care setting - ideally with different provider types (i.e. physician, group, hospital).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
JOB SUMMARY
Provides senior level support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. 20% of travel is expected.
ESSENTIAL JOB DUTIES
- Successfully engages the plan's highest priority, high-volume and strategic complex community providers to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
- Serves as the primary point of contact between Molina health plan and the complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
- Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
- Resolves complex provider issues that may cross departmental lines and involve senior leadership.
- Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
- Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
- Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
- Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
- Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
- Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
- Serves as a subject matter expert for the provider relations function.
- Provides training and support to new and existing provider relations team members.
- Role requires 80%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).
REQUIRED QUALIFICATIONS
- At least 3 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
- Understanding of the health care delivery system, including government-sponsored health plans.
- Understanding of various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for-service (FFS), capitation and various forms of risk, ASO, etc.
- Experience delivering training and facilitating educational presentations.
- Organizational skills and attention to detail.
- Ability to manage multiple tasks and deadlines effectively.
- Interpersonal skills, including ability to interface with providers and medical office staff.
- Ability to work in a cross-functional highly matrixed organization.
- Effective verbal and written communication skills.
- Microsoft Office suite and applicable software programs proficiency.
PREFERRED QUALIFICATIONS
- Experience in provider services, operations, and/or contract negotiations in a Medicaid, Medicare, and/or Marketplace managed health care setting - ideally with different provider types (i.e. physician, group, hospital).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
See All 26 Remote Provider Relations Representative Jobs
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Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services
What Employers Look For
The qualifications that appear most often in remote 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 Remote Provider Relations Representative Job Search
Apply early to remote roles that fit
Migrate Mate lists remote provider relations representative openings from across the U.S. in one place, so you can find roles that match your background and apply directly without sorting through unrelated postings.
Prove your async communication skills upfront
Remote provider relations representatives handle provider inquiries, escalations, and contract questions entirely through email, ticketing systems, and video calls. Show writing samples or document examples that demonstrate you can resolve complex provider issues clearly without back-and-forth.
Highlight self-managed caseloads in your resume
Remote employers need to know you can own a provider portfolio without daily manager check-ins. Quantify how many providers or accounts you managed independently and call out any process you built or improved without on-site support.
Prepare for a remote-specific interview round
Many remote hiring teams add a practical screen, asking you to walk through a provider dispute resolution or contract issue over video. Practice talking through your decision process out loud and have a quiet, professional remote setup ready before your first call.
Remote Provider Relations Representative Jobs: Frequently Asked Questions
How do I get a remote provider relations representative job?
Focus your search on health plans, managed care organizations, and health tech companies that operate distributed teams, since these employers are most likely to hire provider relations representatives remotely. Remote hiring managers screen hard for self-direction, clear written communication, and experience managing provider inquiries or contracts without in-person support. Demonstrating you can resolve issues independently and document outcomes without hand-holding gives you a clear edge.
Which companies hire remote provider relations representatives?
Remote provider relations representative roles are posted by Molina Healthcare, The Emily Program, and Key Family of Companies and others right now, based on current remote listings on Migrate Mate as of September 2026. Remote-first payers, third-party administrators, and distributed health tech firms make up the bulk of employers posting these roles outside a fixed office.
Can you get a remote provider relations representative job with no experience?
Yes, but remote entry-level roles are harder to land because employers expect you to troubleshoot provider issues and manage relationships with minimal supervision from day one. Health tech startups and smaller third-party administrators are the most likely to hire entry-level remotely. Showing familiarity with provider networks, healthcare terminology, or customer-facing roles in a healthcare adjacent setting can open the door when direct experience is thin.
Do you need a degree for remote provider relations representative jobs?
Not always. Many remote employers in managed care and health tech weigh demonstrated provider contracting or customer service experience alongside or instead of a formal degree. What matters most is your ability to resolve provider disputes, communicate clearly in writing, and work through credentialing or contract questions without needing an on-site team around you.
Which industries hire the most remote provider relations representatives?
Remote provider relations representative roles concentrate in Healthcare & Medical Services, based on current remote listings on Migrate Mate as of September 2026. These sectors rely on distributed teams that manage provider networks across wide geographic areas, making the role a natural fit for fully remote work.
See All 26 Remote Provider Relations Representative Jobs
Find roles that match your experience and apply in just a few clicks.
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