Direct end‑to‑end onboarding, provider education, webinars, portal training, EFT setup, credentialing coordination, and directory validation.Standardize onboarding checklists, timelines, and handoffs with Credentialing, Provider Data, and Contracting; ensure accurate participation activation and directory integrity.Develop targeted training and communications for provider segments and roles; measure adoption, comprehension, and impact on operational metrics.Provider Operations & Issue ResolutionOversee intake and resolution of issues spanning claims, credentialing, enrollment, provider data, contracts, and portal support; manage queues and case aging.Remove blockers, rebalance work, and escalate cross‑functional dependencies; ensure SLA adherence and clear provider communication.Lead root‑cause analysis and corrective actions to reduce repeat issues; coordinate with Claims, Data, and IT on systemic fixes and configuration updates.Analytics, Reporting & Continuous ImprovementDevelop dashboards and routine reporting on satisfaction, first‑contact resolution, onboarding timeliness, issue aging, portal adoption, quality scores, productivity, and SLA compliance.Drive continuous improvement across intake, documentation, handoffs, and communication; implement automation or templates where feasible.Use data insights to prioritize provider outreach, education topics, and process enhancements; present recommendations and action plans to leadership.Cross‑Functional CollaborationPartner with Provider Data, Credentialing, Contracting, Claims, Finance, Clinical Operations, Communications, and IT on shared initiatives and process improvements.Align provider communications with contracting terms, credentialing requirements, portal capabilities, and claims processes; ensure consistency and clarity.Lead provider meetings and cross‑functional workgroups; track actions to completion and report outcomes.Risk, Compliance & Stakeholder ManagementEnsure compliance with organizational policies, privacy/security requirements, and applicable regulations; maintain audit‑ready documentation.Support audits and quality reviews; develop corrective action plans and monitor remediation; maintain confidentiality of provider information.Communicate status, risks, and recommendations to executive stakeholders; prepare materials for business reviews and governance committees.What you'll Need:Bachelor’s degree required; Master’s preferred.7–10 years of experience in provider relations/network operations or related provider‑facing functions (onboarding, education, escalation management).3+ years of supervisory/people leadership experience leading provider relations or customer operations teams.Demonstrated expertise in provider engagement, onboarding, education, and issue resolution; strong analytical and written/verbal communication skills.Proficiency with provider portals, CRM/case management tools, and collaboration platforms; advanced Excel/Sheets capability.
