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Provider Relations Rep

System One • Baltimore, MD • 4h ago

Job Title: Provider Relations Rep

Location: Once a month Onsite meetings in Owings Mills, Baltimore or Columbia, MD.

Type: Contract

Compensation: $35/HR

Contractor Work Model: Mostly Remote

The Provider Relations Representative is responsible for developing and maintaining positive relationships with healthcare providers, operational departments, health institutions, and other key partners. This role serves as the primary liaison to communicate, educate, and support network providers while managing escalated issues and facilitating dispute resolution.

Essential Functions:

Partner with the Provider Training and Education Department to educate providers on programs and processes that enhance member experiences. Deliver ongoing and targeted training to ensure providers effectively use electronic tools, the provider portal, and follow established procedures.

Support assigned health systems or networks, representing multiple practices to ensure Tier One service delivery and operational excellence.

Conduct research, analysis, and resolution for special projects, ensuring timely and accurate outcomes.

Provide analytical support and resolution for special cases and projects. Ensure policies and contractual guidelines are followed. Respond verbally or in writing to inquiries from management and internal or external stakeholders. Act as a resource for providers in resolving escalated service-related issues through various communication channels (in person, phone, email, etc.).

Build and maintain strong provider relationships through regular communication and timely issue resolution. Leverage these relationships to drive provider engagement and promote favorable outcomes.

Proactively identify provider needs, address concerns, and coordinate with internal or external resources to ensure high-quality service and support.

Education & Experience:

Education: High School Diploma required. Bachelor's Degree in Business, Healthcare Administration, or a related field preferred.

Experience: Minimum 4 years of experience in the healthcare industry, including experience working with providers, training, claims, customer service, or presenting information to external audiences.

Experience with a health insurance plan, hospital, or physician/hospital organization (PHO) preferred.

System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

M2

LI-AJ1

Ref: #850-Rockville (ALTA IT)

System One, and its subsidiaries including Joulé, ALTA IT Services, CM Access, TPGS, and MOUNTAIN, LTD., are leaders in delivering workforce solutions and integrated services across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

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