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
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