Provider Relations Lead
$48.7k - $50kAlivi TPA of Florida, LLC
- Location Remote - Miami, FL, United States
- Base Pay $48,696.00 - $50,000.00 / Year
- Job Category Provider Relations Lead, NEMT Provider Relations, Hiring PR Lead
- Employee Type Regular Full Time
- Required Degree NONE
- Manage Others Yes
Description
Duties and Responsibilities
- 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 provider’s offices and facilities as required.
- Perform other duties as assigned to support network operations and company goals.
Requirements
Requirements & Qualifications:
- High school diploma or equivalent required; bachelor’s degree preferred.
- Minimum of 3–5 years of experience in provider relations, NEMT operations, or healthcare network management.
- Experience managing or supervising a team preferred.
- Strong knowledge of Microsoft Word, Excel, PowerPoint, Outlook, and CRM systems (e.g., Salesforce).
- Excellent leadership, communication, customer service, problem-solving, and analytical skills.
- Ability to work independently and collaboratively in the field or office.
- Observational, investigative, and process-oriented with attention to detail.
- Knowledge of vehicle safety, inspection standards, and operational compliance protocols.
Summary
The Provider Relations Lead is responsible for managing and overseeing a regional network of NEMT providers and supervising Provider Relations Representatives (PRRs). This role ensures network adequacy, provider compliance, and high-quality service while building strong relationships with providers and facilities. The PRL leads operational initiatives, monitors performance metrics, and provides guidance, training, and support to their team.
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