Provider Relations Representative
Are you passionate about building strong relationships and supporting healthcare providers? As a Provider Relations Representative, you'll be the go-to contact for a panel of providershelping them navigate policies, processes, and systems to deliver quality care to our members.
This role combines customer service, education, and field engagement. You'll spend time both in the office and in the community, ensuring providers have the tools and support they need.
This is a hybrid role that offers a dynamic mix of community engagement and flexibility. In this role you will travel to meet with providers and attending local events. You will also have occasional in-office meetings, while also enjoying options to work from home.
What You'll Do :
- Serve as the primary contact for assigned providers, offering guidance on claims, authorizations, credentialing, and contracting.
- Build strong relationships through regular outreach, meetings, and follow-ups.
- Educate providers on Community Care policies, procedures, and product differences.
- Coordinate service schedules and ensure consistent phone coverage with your team.
- Maintain accurate documentation of provider interactions and action plans.
- Support provider onboarding, orientations, and training sessions.
- Collaborate with internal teams to resolve provider issues and share feedback.
- Travel within the network for face-to-face meetings and community engagement events.
- Facilitate meetings with high-needs providers and external stakeholders.
- Contribute to provider newsletters, manuals, and educational materials.
What We're Looking For :
Strong communication and relationship-building skillsAbility to manage multiple priorities and work independentlyWillingness to travel based on business needsKnowledge of healthcare operations and provider servicesBachelor's degree in healthcare, human services, or a related field2 years of experience in a complex organizational environmentExperience in behavioral health services or knowledge of the behavioral health provider system strongly preferredExcellent written and verbal communication skillsAbility to clearly and consistently explain standards of care and provider agreementsAt least 2 years of experience in a healthcare or managed care settingUnderstanding of public and private behavioral health care delivery systemsLicensure, Certifications, and Clearances : Act 34UPMC is an Equal Opportunity Employer / Disability / Veteran