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Job description
Description The Provider Relations Intake Specialist serves as the centralized point of contact for provider network changes within Managed Care Operations. This role coordinates and tracks provider additions, changes, and terminations while supporting accurate provider data, health plan submissions, and timely processing across the provider lifecycle.
Key Responsibilities:
Manage and track provider-related requests, including new provider additions, demographic and practice changes, and terminations.
Review and validate provider rosters and reconcile discrepancies across medical group systems, health plans, credentialing, contracting, and configuration records.
Support health plan roster submissions, provider directory accuracy, health plan activation, and management of health plan IDs.
Collaborate with Provider Relations, Contracting, Credentialing, Configuration, Claims, Billing, Finance, Member Services, Quality, and Compliance to coordinate provider changes.
Monitor requests through completion, proactively follow up on delays, and escalate stalled requests as needed.
Maintain accurate, audit-ready documentation and support compliance, regulatory, and process improvement initiatives.
Salary Range: $31.99 - $50.24/hourly
Qualifications All items listed below are required :
High school diploma
Two years or more of Healthcare managed care operations, IPA, or MSO provider relations experience
Two years or more of working knowledge of required credentialing documents, contracting terminology, or network operations
Two years or more of understanding of the handoffs between Provider Relations, Contracting, Credentialing, and Configuration, i.e., Provider Lifecycle Management (PLM)
Two years or more of experience with provider rosters, credentialing data, and health plan submissions
Two years or more of proficiency with Microsoft Office (Word, Excel, Outlook Teams)
Strong understanding of contracted health plans and provider relationships
Skilled in documenting with high attention to detail and data accuracy
Ability to manage high-volume intake in an enterprise environment
Strong communication skills with providers, practice staff, internal, and external stakeholders
Comfort working in remote or hybrid environments using collaboration tools. Ability to work departmental hours of Monday - Friday 8am - 5pm
All items listed below are preferred:
Associate or bachelor's degree preferred; and/or equivalent combination of education and experience.
Proficiency of PLM or CRM software
Understanding of credentialing documentation requirements and roster standards
Familiarity with provider contract terminology
Problem-solving mindset with ability to identify root causes of data discrepancies
Ability to work independently with minimal supervision
Ability to research provider issues using multiple data sources
Understanding of root cause analysis to prevent repeat issues
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.