Provider Relations Lead

Alivi TPA of Florida, LLC
  • Miami, FL
  • Full-time
10 days ago

Job Description

Duties and Responsibilities Provider Network Oversight Serve as the primary liaison for all providers in the assigned region, ensuring network issues are addressed promptly.Lead, coach, and support Provider Relations Representatives in their daily activities, including provider training, field observations, and compliance monitoring.Ensure providers follow policies, procedures, and service expectations.Conduct quarterly reviews with providers to assess performance, address concerns, and strengthen relationships.Oversee credentialing compliance and maintain accurate provider documentation.Review provider performance reports, including On-Time Performance (OTP), missed trips, and driver adherence metrics, and implement improvement plans as needed. Network Adequacy & Growth Identify gaps in provider coverage and develop strategies to recruit, negotiate, and contract new providers.Maintain adequate provider coverage in assigned regions to meet Health Plan requirements.Support PRRs in recruiting and onboarding providers. Field & Compliance Leadership Conduct or oversee field observations to monitor vehicle safety, provider performance, and service quality.Ensure PRRs complete scheduled facility visits and provider observations.Investigate escalated complaints or operational issues and implement corrective actions. Team Management & Reporting Supervise and mentor PRRs, setting goals, providing feedback, and monitoring performance. Ensure all provider-related reports and operational data are submitted accurately and on time.Analyze network performance metrics and identify opportunities for improvement.Act as the primary point of escalation for provider or facility concerns. Other Responsibilities Travel to providers offices and facilities as required.Perform other duties as assigned to support network operations and company goals.

Numbers & Facts

LocationMiami, FL
Job TypeFull-time

Skills

  • Coachingunmatched
  • Contract Negotiationunmatched
  • Corrective Actionunmatched
  • Documentationunmatched
  • Health Planunmatched
  • Improvement Metricsunmatched
  • Leadershipunmatched
  • Maintain Complianceunmatched
  • Mentoringunmatched
  • Network Administration/Managementunmatched
  • Network Monitoringunmatched
  • Network Performance/Analysisunmatched
  • Network Supportunmatched
  • Onboardingunmatched
  • Performance Analysisunmatched
  • Performance Metricsunmatched
  • Problem Solving Skillsunmatched
  • Provider Contractingunmatched
  • Provider Relationsunmatched
  • Recruiting Strategyunmatched
  • Reporting Skillsunmatched
  • Set Goalsunmatched
  • Strategic Planningunmatched
  • Team Lead/Managerunmatched
  • Time Managementunmatched
  • Training/Teachingunmatched
  • Willing to Travelunmatched

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