Provider Partnership Associate

The Provider Partnership Associate (PPA) will cultivate and maintain relationships with institutional and professional providers, ensuring compliance with contractual obligations, regulatory requirements, and corporate policies. The role involves researching, analyzing, and resolving provider issues to achieve expected outcomes within set timeframes, providing education on new products and network initiatives, and handling claims and payment matters. Responsibilities Perform research and analysis of all provider issues received externally and internally to ensure goals/outcomes are achieved within set timeframes. Attend onsite, face‑to‑face, or virtual visits with all provider types and administrators to communicate changes and provide issue resolution. Develop and deliver provider education and issue resolution in pursuit of network strategies (product portfolio & changes, payment policy changes, reimbursement methodologies, PEAR/other provider tools, clinical initiatives, etc.). Ensure key goals and objectives are accomplished in keeping with established priorities and timeframes. Work with Network Operations or other areas at AmeriHealth New Jersey or FOC to identify and resolve provider issues. Establish and maintain effective relationships with practice administrators, medical directors, and practitioners to ensure compliance with contractual obligations, regulatory requirements, accreditation standards, and corporate policies. Provide claims issue resolution from root‑cause identification through communication of outcome to provider. Facilitate provider demographic changes with Provider Data Administration. Address provider issues using the required ticket and inquiry tracking system processes. Discuss and propose recommendations to management to support provider engagement strategies and overall provider experience. Complete assigned projects to support corporate initiatives within the timeframe set by management. Support other team members to ensure service levels and goals are met. Perform other duties as assigned. Experience 3-5 years of provider relations or managed care contracting experience. Claims processing, customer service, and/or managed care experience preferred. Skills Proficient in Microsoft Office Suite. Excellent oral and written communication skills. Ability to work independently and within a team. Must have an Android or iOS device compatible with the free Microsoft Authenticator app. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. #J-18808-Ljbffr Independence Blue Cross