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Provider Relations Lead

$48.7k - $50k

Alivi 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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Vacancy posted 16 hours ago
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