Provider Relations Manager (WI)

Job Description

Job Description

Position contingent upon award of contract.

POSITION LOCATION IS IN THE STATE OF WISCONSION

 

SUMMARY

 

Responsible for the development, management, and performance of the Wisconsin transportation provider network, ensuring adequate statewide coverage, capacity, and service delivery. Oversees provider recruitment, contracting, credentialing, and ongoing network maintenance to ensure transportation providers meet contractual, operational, and performance requirements. Monitors provider capacity, transportation mode availability, and trip volume distribution to support service efficiency, network stability, regulatory compliance, and continuous performance improvement.

 

ESSENTIAL FUNCTIONS

• Recruit, contract, onboard, and maintain a high-performing network of NEMT providers to ensure adequate coverage, capacity, and service availability across all transportation modes and service regions.
• Develop and maintain strong relationships with prospective and existing providers, serving as a subject matter expert on provider operations, network participation, contractual requirements, and business success strategies.
• Coordinate provider application processing, credentialing, contracting, implementation, and operational readiness, including technology adoption, service expectations, and compliance requirements.
• Provide orientation, onboarding, training, and ongoing education to providers regarding contractual obligations, operational standards, compliance requirements, claims processes, and network policies.
• Collaborate with Compliance, Quality Assurance, Operations, and Dispatch teams to ensure providers maintain regulatory compliance, meet performance expectations, and receive appropriate trip assignments based on demand, capacity, and performance.
• Monitor provider performance, network utilization, and service quality; identify performance gaps and coordinate corrective action plans, remediation efforts, and continuous improvement initiatives.
• Analyze network capacity, provider performance, trip volume trends, and market needs to develop network adequacy plans, contingency coverage strategies, surge response plans, and provider recruitment initiatives.
• Negotiate provider contracts and reimbursement rates that support organizational objectives while maintaining provider engagement and network stability.
• Assist providers in improving operational efficiency, fleet utilization, trip routing, profitability, and overall business performance.
• Serve as a resource to providers regarding claims processing, reimbursement issues, operational concerns, and network-related questions.
• Prepare and analyze reports related to provider performance, network adequacy, capacity planning, recruitment efforts, and operational trends; provide recommendations for network enhancements and strategic growth.
• Facilitate provider meetings, town halls, training sessions, and other engagement activities to strengthen provider partnerships and communication.
• Travel up to 50% as required to support provider recruitment, relationship management, training, operational assessments, and network development activities.
• Perform other duties as assigned.

QUALIFICATIONS REQUIRED

• Demonstrated experience developing, managing, and optimizing NEMT or transportation provider networks across diverse geographic service areas.
• Strong knowledge of provider contracting, credentialing, network adequacy standards, capacity planning, and transportation operations across multiple service modes.
• Proven ability to analyze provider performance, operational metrics, and network utilization data, and implement corrective action plans in collaboration with Quality Assurance, Compliance, and Operations teams.
• Proven leadership skills with experience supporting provider recruitment, onboarding, retention, performance improvement, and relationship management initiatives.
• Excellent written, verbal, and interpersonal communication skills, with the ability to effectively engage providers, internal stakeholders, Department representatives, and executive leadership.
• Strong analytical, organizational, and project management skills, with the ability to manage multiple priorities, maintain contingency and surge response plans, and meet deadlines in a fast-paced environment.
• Self-motivated, results-oriented professional with the ability to work independently, exercise sound judgment, take initiative, and perform effectively under pressure.
• Demonstrated commitment to accountability, professionalism, confidentiality, and ethical business practices.
• Ability to foster a positive team environment through coaching, collaboration, recognition, and constructive feedback.
• High level of proficiency with transportation management systems, reporting platforms, Microsoft Office Suite, and other business applications, with advanced knowledge of Microsoft Excel and Word preferred.
• Ability to adapt to changing priorities, business needs, and operational environments while maintaining flexibility and responsiveness.
• Professional appearance and positive attitude.
• Valid driver's license with a clean driving record.
• Military, EMS, public transportation, healthcare transportation, or related industry experience preferred.
• Ability to successfully pass all required background, credit, and pre-employment screening requirements.

 

MINIMUM REQUIRED EDUCATION (PREFERRED)

5+ years provider network leadership experience in transportation or healthcare service delivery.

Bachelor's degree (B. A.) from four-year College or University or equivalent combination of education and experience.