Provider Relations Specialist - Remote

Overview

The Provider Relations Specialist plays a vital role in strengthening the relationship between Carolina Complete Health Network (CCHN), its provider partners, and affiliated health plans, ensuring smooth coordination across healthcare providers.

In Short

• Serve as the primary contact for Medicaid and Marketplace Healthcare Providers.
• Field inquiries from the provider network via phone.
• Act as a liaison between Providers, PHP, and other stakeholders.
• Investigate and resolve Provider questions and issues.
• Educate Providers on CCH processes and operations.
• Coordinate and negotiate contracts.
• Facilitate provider set-up and contract configuration.
• Assist in developing the healthcare provider network plan.
• Maintain the Provider CRM and contract database.
• Ensure State compliance with health plan contracts.

Requirements

• Bachelor's degree in Healthcare Administration or related field.
• Excellent communication skills.
• Ability to handle multiple tasks in a fast-paced environment.
• Strong critical thinking capabilities.
• Demonstrated ownership mindset and customer service focus.
• Knowledge of healthcare, managed care, or Medicaid insurance is a plus.
• Willingness to problem solve and take action.
• Current state driver's license.
• Reliable transportation for occasional in-person events.
• Reliable, high-speed internet for remote work.

Benefits

• Medical, Dental, and Vision insurance with premium coverage.
• Short/Long Term Disability and Supplemental Life Insurance.
• Annual wellness reimbursement.
• 401k with company match.
• Paid parental leave.
• Paid time off.