Provider Relations Representative

Location: Springfield, Illinois, United States; hybrid/flex schedule with three days per week in the office and two days working from home. Travel within assigned areas, including overnight stays, is required. Relocation is not available.

Base pay: $63,300–$114,300 annually. The role also aligns with an annual incentive bonus plan.

Company

hirify.global provides health insurance and managed care services through Blue Cross-branded health plans.

What you will do

• Manage contracting, credentialing, and maintenance of professional provider data across lines of business.
• Build relationships with hospitals, physicians, surgery centers, behavioral health facilities, VA hospitals, and allied professional providers.
• Support data integrity and high-quality provider network initiatives.
• Research and resolve issues involving provider credentialing, data, claims, and network participation.
• Deliver training and education to contracted providers and participate in internal meetings and work groups.
• Coordinate operational and customer support activities while identifying business and process improvements.

Requirements

• Bachelor’s degree and three years of managed care experience, or at least five years of managed care experience.
• At least two years of healthcare administration experience in clinical and financial settings, including direct provider communication.
• Knowledge of healthcare, contracts, applications, products, provider reimbursement methods, and claims processing systems.
• Strong interpersonal, analytical, presentation, organizational, planning, and communication skills.
• Ability to work independently, meet deadlines, handle pressure, and travel within assigned areas.
• PC skills, including Word, Excel, and PowerPoint.

Nice to have

• Experience analyzing provider performance, utilization, or operational metrics.
• Experience with provider onboarding, network expansion, value-based programs, or provider engagement.
• Advanced Excel skills, including pivot tables, data validation, and large datasets.
• Knowledge of claims, billing, coding basics, CRM systems, or provider management systems.
• Experience with government agencies, legislative groups, advocacy groups, or IAMHP.

Culture & Benefits

• Curated development plans and professional growth opportunities.
• Health and wellness benefits, 401(k) savings plan, pension plan, and paid time off.
• Paid parental leave, disability insurance, supplemental life insurance, and an employee assistance program.
• Paid holidays, tuition reimbursement, and additional incentives.
• Visa sponsorship is not available now or in the future.