Provider Relations Representative Jobs in USA with Visa Sponsorship
Provider Relations Representatives work in healthcare administration coordinating between insurers, hospitals, and medical networks. Employers in managed care and health systems regularly sponsor H-1B visa and TN visas for qualified candidates with degrees in healthcare administration, public health, or business. For detailed occupation requirements, see the O*NET profile.
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Get Access To All JobsINTRODUCTION
The Associate Provider Relations Representative supports provider outreach and education related to provider compliance with health plan operations and regulatory requirements. Interacts regularly with team members and key internal stakeholders in understanding provider requirements and challenges and develop processes needed to ensure success of department goals. This position builds and maintains positive working relationships with providers, effectively communicating with and educating those providers about the organization, provider responsibilities and resolving provider inquiries.
Duties and Responsibilities:
Responsibilities include, but are not limited to:
- Handle mandatory provider training tracking and outreach processes. Run reports out of Salesforce, review and follow-up as needed.
- Add, update, and maintain provider data in accordance with internal policies and procedures.
- Ensure provider email distribution lists are accurate and up to date.
- Handle Provider Relations requests from other departments by triaging and/or resolving issues timely.
- Ensure Salesforce reporting captures requirements needed for training and other PR interactions.
- Perform follow up on any provider non-compliance related to access and availability surveys.
- Perform other outreach or tasks as needed to support provider education and compliance.
- Assist in finding opportunities for provider training and education.
- Work collaboratively interdepartmentally to resolve provider issues to ensure an adequate and satisfied provider network.
- Respond to a high volume of provider inquiries while ensuring consistent follow through on resolution of issues.
- Assist in finding opportunities to improve the provider experience and participate in implementing provider satisfaction initiatives.
- Orient providers on Neighborhood’s policies related to claims; benefits; clinical programs; referral and authorization; regulatory compliance; billing and payments; complaints and appeals; policies and procedures.
- Support Provider Relations team with the development and maintenance of strong professional relationships with providers while functioning as a liaison to the provider community.
- Participate in departmental and interdepartmental meetings as appropriate and necessary.
- Participate in the development of departmental policies, procedures and processes.
- Maintain professional growth and development.
- Represent organization at provider related events and other initiatives, as necessary.
- Other duties as assigned.
QUALIFICATIONS REQUIRED:
- Bachelor’s degree in Health Administration, Business Administration, Public Health or a related field or an equivalent amount of education and experience.
- Experience with a managed care organization or a health care related organization (e.g. HMO, Medicaid, Medicare).
- Intermediate to Advanced skills in Microsoft Office (Word, Excel, Outlook).
- Ability to interact well with individuals on all levels, and maintain a professional image and attitude.
- Ability to manage data and processes in multiple platforms.
- Ability to work cross-organizationally to achieve the goals of the company and department.
- Ability to work independently.
- Detail oriented, with the ability to organize and ability to handle multiple projects simultaneously.
- Excellent Customer Service and communication (written and verbal) presentation and facilitation skills.
- Strong analytical and problem-solving skills.
- Possess a general understanding of provider and claim operations as they relate to health plans.
PREFERRED:
- Understanding of provider’s reimbursement methodologies and contract terms.
- Experience with facility or professional provider relations.
- Experience in SharePoint.
- Experience with commercial, Medicaid or Medicare reimbursement mechanisms.
- Knowledge of Quality Improvement Processes (e.g. Lean, Six Sigma).
Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
INTRODUCTION
The Associate Provider Relations Representative supports provider outreach and education related to provider compliance with health plan operations and regulatory requirements. Interacts regularly with team members and key internal stakeholders in understanding provider requirements and challenges and develop processes needed to ensure success of department goals. This position builds and maintains positive working relationships with providers, effectively communicating with and educating those providers about the organization, provider responsibilities and resolving provider inquiries.
Duties and Responsibilities:
Responsibilities include, but are not limited to:
- Handle mandatory provider training tracking and outreach processes. Run reports out of Salesforce, review and follow-up as needed.
- Add, update, and maintain provider data in accordance with internal policies and procedures.
- Ensure provider email distribution lists are accurate and up to date.
- Handle Provider Relations requests from other departments by triaging and/or resolving issues timely.
- Ensure Salesforce reporting captures requirements needed for training and other PR interactions.
- Perform follow up on any provider non-compliance related to access and availability surveys.
- Perform other outreach or tasks as needed to support provider education and compliance.
- Assist in finding opportunities for provider training and education.
- Work collaboratively interdepartmentally to resolve provider issues to ensure an adequate and satisfied provider network.
- Respond to a high volume of provider inquiries while ensuring consistent follow through on resolution of issues.
- Assist in finding opportunities to improve the provider experience and participate in implementing provider satisfaction initiatives.
- Orient providers on Neighborhood’s policies related to claims; benefits; clinical programs; referral and authorization; regulatory compliance; billing and payments; complaints and appeals; policies and procedures.
- Support Provider Relations team with the development and maintenance of strong professional relationships with providers while functioning as a liaison to the provider community.
- Participate in departmental and interdepartmental meetings as appropriate and necessary.
- Participate in the development of departmental policies, procedures and processes.
- Maintain professional growth and development.
- Represent organization at provider related events and other initiatives, as necessary.
- Other duties as assigned.
QUALIFICATIONS REQUIRED:
- Bachelor’s degree in Health Administration, Business Administration, Public Health or a related field or an equivalent amount of education and experience.
- Experience with a managed care organization or a health care related organization (e.g. HMO, Medicaid, Medicare).
- Intermediate to Advanced skills in Microsoft Office (Word, Excel, Outlook).
- Ability to interact well with individuals on all levels, and maintain a professional image and attitude.
- Ability to manage data and processes in multiple platforms.
- Ability to work cross-organizationally to achieve the goals of the company and department.
- Ability to work independently.
- Detail oriented, with the ability to organize and ability to handle multiple projects simultaneously.
- Excellent Customer Service and communication (written and verbal) presentation and facilitation skills.
- Strong analytical and problem-solving skills.
- Possess a general understanding of provider and claim operations as they relate to health plans.
PREFERRED:
- Understanding of provider’s reimbursement methodologies and contract terms.
- Experience with facility or professional provider relations.
- Experience in SharePoint.
- Experience with commercial, Medicaid or Medicare reimbursement mechanisms.
- Knowledge of Quality Improvement Processes (e.g. Lean, Six Sigma).
Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
See all 42+ Provider Relations Representative Jobs
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Get Access To All JobsTips for Finding Provider Relations Representative Jobs
Target managed care and health plan employers
Large health insurers and managed care organizations file Labor Condition Applications for Provider Relations roles far more frequently than smaller clinics. Focus your search on employers with established HR infrastructure and a track record of sponsoring work visas.
Align your degree to the specialty occupation standard
H-1B approval depends on showing the role requires a specific bachelor's degree. Degrees in healthcare administration, public health, or business administration are the strongest fit for Provider Relations positions and support the specialty occupation argument most directly.
Highlight network contracting and credentialing experience
Employers sponsoring visas want candidates who reduce onboarding risk. Concrete experience with provider credentialing, contract negotiation, or claims resolution signals immediate value and strengthens the business case a hiring manager must make to justify sponsorship.
Understand TN eligibility if you hold Canadian or Mexican citizenship
TN visa classification covers certain business and management roles under USMCA. If your degree is in a qualifying field like business administration, TN may be available without the H-1B lottery, giving you a faster path to starting work.
Address the specialty occupation question proactively
Provider Relations is a role USCIS scrutinizes for H-1B eligibility. Come prepared to explain why your specific position requires a degree in a particular field, not just any bachelor's degree, using your job description and employer documentation as evidence.
Build experience in health information systems
Familiarity with systems like Epic, Facets, or similar provider management platforms strengthens your profile significantly. Employers sponsoring visas are especially motivated when candidates bring technical skills that are harder to source domestically on short timelines.
Frequently Asked Questions
Do employers commonly sponsor visas for Provider Relations Representative roles?
Sponsorship exists but is more common at large managed care organizations, regional health plans, and hospital networks than at smaller practices. Employers with dedicated HR and legal teams are better positioned to navigate H-1B visa filings. You can browse sponsoring employers currently hiring on Migrate Mate to identify which organizations have active openings.
Does a Provider Relations Representative role qualify as an H-1B specialty occupation?
It can qualify, but USCIS scrutinizes administrative healthcare roles closely. The key is demonstrating that the specific position requires a degree in a particular field, such as healthcare administration or public health, not just any bachelor's degree. Job descriptions that list specific degree requirements and employers who document this requirement in writing have stronger petition outcomes.
What degrees support an H-1B or work visa petition for this role?
Healthcare administration, public health, business administration, and health informatics are the most defensible degree fields for Provider Relations positions. A general business or communications degree can work if the employer's job description ties the role's duties directly to that field of study. The degree-to-job match is the core of the specialty occupation argument.
Can a Canadian citizen get a TN visa for a Provider Relations Representative position?
Possibly, if the role fits a covered TN category and your degree aligns. Management consultant or certain scientific or business analyst categories have been used for healthcare administrative roles, but TN classification requires a clear match between the USMCA category, the job duties, and your credentials. An immigration attorney can assess your specific situation before you apply.
What should I expect during the H-1B petition process for this type of role?
Your employer files a Labor Condition Application with the Department of Labor first, then submits Form I-129 to USCIS after the H-1B lottery selection. For administrative healthcare roles, USCIS sometimes issues Requests for Evidence challenging specialty occupation status. Having a detailed job description, an employer support letter explaining degree requirements, and documentation of your credentials reduces the risk of delays.
What is the prevailing wage requirement for sponsored Provider Relations Representative jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.