Provider Relations Representative

Located In:

Boynton Beach, Florida 33437

The Provider Relations Representative is responsible for developing and maintaining positive relationships with physicians, providers, and practice managers across our provider network. This role oversees provider performance in incentive and value-based programs, addresses educational needs for providers and office staff, and facilitates solutions for network service issues. Serving as the primary contact, the Provider Relations Representative provides education, technical assistance, and problem-solving support while helping build a strong and engaged provider network.

Key Responsibilities

• Develop and maintain strong provider relationships, ensuring adherence to contractual requirements.

• Educate providers and office staff on health plan operations, policies and procedures, preventative care, quality outcomes, and risk adjustment.

• Track, monitor, and report on program performance metrics (e.g., STARs, HEDIS, quality performance measures).

• Prepare for and participate in provider meetings, creating agendas and delivering presentations.

• Partner with providers and office staff to support membership growth and member retention.

• Resolve provider complaints and ensure complaint processes are appropriately managed.

• Deliver regular educational updates to providers and staff regarding value-based care (VBC).

• Perform additional duties as assigned.

Skills & Competencies

• Proven record of driving successful outcomes.

• Proficiency in Microsoft Office (Excel, Word, Access, etc.).

• Skilled in organizing and leading virtual meetings (Zoom, Teams, WebEx, etc.).

• Excellent verbal and written communication skills.

• Strong interpersonal and relationship management abilities.

• Ability to manage projects in a fast-paced, dynamic environment.

• Strong analytical and problem-solving skills with keen attention to detail.

• High energy and collaborative mindset.

Qualifications

• High school diploma/equivalent required; Associate or Bachelor’s degree preferred.

• Knowledge of provider reimbursement, Medicare reimbursement, coding, HEDIS measures, and care gap reporting preferred.

• Familiarity with provider office dynamics and effective communication/education strategies.

• Understanding of reimbursement models (FFS, CPT coding, etc.).

• Knowledge of MRA & VBC strongly preferred.

• Experience in customer service, provider relations, or healthcare-related roles required.

Physical Demands

• Ability to travel 30–50% monthly.

• Must be able to transition comfortably between different work positions.

• Ability to lift and move up to 35 pounds as needed.

• May involve occasional bending, stooping, kneeling, or reaching.

• Frequent use of computers and phones required.

Here are just a few things we offer:

• Access to health, dental, and vision insurance

• Health Savings Account

• Eligible for PTO and Holiday pay

• Company paid life insurance.

• Access to voluntary short and long-term disability insurance

• Access to additional life insurance

• Access to Accident and Critical Illness Insurance

• 401K with automatic employer contribution

Medical Specialists of the Palm Beaches, Inc. (“MSPB”) is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind: MSPB is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at MSPB are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. MSPB will not tolerate discrimination or harassment based on any of these characteristics. MSPB encourages applicants of all ages.