Provider Relations Officer

Responsibilities

• Performs completed staff work to ensure availability of relevant, trusted healthcare and benefits providers and physicians (i.e. data collection, prepare presentation materials, reviews and evaluates application & submitted documentary requirements, etc.);
• Negotiates contracts that comply with industry regulations applying risk minimizing techniques;
• Initiates collaboration with other Maxicare divisions/departments to identify and pursue better provider networks.
• Negotiate terms and conditions of contracts with healthcare providers, ensuring alignment with organizational objectives and regulatory requirements
• Provides inputs and ensures the drafting, reviewing, and finalization of contracts;
• Serves as the primary point of contact for contract-related inquiries and issues;
• Collaborates cross-functionally with internal Maxicare divisions or departments such as legal, finance, operations, and provider network management to ensure seamless contract execution and alignment with organizational objectives.
• Conducts regular business review, Provider & Physician’s performance evaluation and attends to/resolves other relevant issues and concerns raised by both internal and external stakeholders
• Implements appropriate provider development strategy to ensure a culture of collaboration, continuous improvement, and shared success with th e partner provid ers
  
  

• Experience in HMO and Insurance is an advantage
• Strong negotiation and presentation skils
• Strong client relationship