Provider Relations Lead
Duties and Responsibilities
Provider Network Oversight
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 & Qualifications:
High school diploma or equivalent required; bachelor's degree preferred.
Bilingual (English/Spanish) 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.
The Provider Relations Lead is responsible for managing and overseeing a regional network of NEMT providers and supervising Provider Relations Representatives (PRRs). We are seeking a Provider Relations Lead based in the Jacksonville, Florida area to ensure 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.