Role OverviewJoin a mission-driven organization focused on improving healthcare for seniors by serving as a key liaison between provider networks and care delivery. In this field-remote position based in the San Antonio or New Braunfels, TX region, you will work directly with physician practices and provider groups to strengthen partnerships, enhance clinical outcomes, and support operational success. Your efforts will directly contribute to expanding access to high-quality care and advancing key performance metrics.
Key Responsibilities
- Establish and nurture long-term relationships with providers and office staff to support network retention, growth, and performance improvement.
- Guide providers in meeting key performance goals, including Annual Wellness Visits, HEDIS measure completion, risk adjustment accuracy, and reduced hospital utilization.
- Lead onboarding sessions and ongoing education on clinical programs, benefits, incentives, compliance standards, and care models.
- Develop training materials, implementation guides, and in-service presentations tailored to provider needs.
- Act as the primary contact for resolving issues related to prior authorizations, claims, data reporting, eligibility, and directory accuracy.
- Represent the organization at provider meetings, community events, and educational trainings.
- Document interactions, track progress, and maintain accurate records in internal systems.
- Support contract execution, credentialing, and network documentation processes.
- Submit regular activity summaries and participate in team meetings and special projects as needed.
Qualifications
Candidates should have at least two years of experience in provider relations, contracting, or a related healthcare field, preferably within an HMO, IPA, or medical group setting. A bachelor’s degree or equivalent experience is required. Strong analytical thinking, attention to detail, and communication skills are essential. You must be comfortable presenting to diverse audiences and managing multiple priorities independently.
Proficiency with Microsoft Word, Excel, and PowerPoint is expected. This role requires up to 80% local travel by car, with occasional air travel. A valid driver’s license, reliable vehicle, and auto insurance are mandatory. Flexibility to work early mornings or evenings for provider meetings is necessary. Bilingual English/Spanish skills are an asset.
Work Environment
This is a remote-based role with primary responsibility for Bexar and Comal Counties. Work hours align with standard provider office schedules, Monday through Friday, with flexibility to accommodate community engagements. Remote work is permitted per company policy. Mileage and travel expenses are reimbursed.
