Provider Relations Specialist (Healthcare)

TL;DR

Provider Relations Specialist (Healthcare): Serves as a relationship and operational liaison between healthcare providers and Care Management/Utilization Management programs with an accent on provider engagement, education, and issue resolution. Focus on streamlining intake and prior authorization workflows, ensuring compliant high-quality care, and enhancing the overall provider experience.

Location: Remote (United States)

Compensation: $24–$29 per hour

Company

hirify.global created a personalized health platform integrating health plan administration, holistic wellbeing solutions, and comprehensive care navigation.

What you will do

• Act as the primary point of contact for CM/UM programs and prior authorization workflows on the MyCare Platform.
• Build and maintain professional relationships with provider offices and facilities through outbound outreach.
• Research and resolve routine provider inquiries and operational issues within defined turnaround times.
• Educate provider staff on submission requirements, documentation, and available resources.
• Collaborate with internal teams (Intake, Claims, Network, Operations) to resolve concerns and monitor requests to closure.
• Document all provider interactions and outcomes accurately while adhering to HIPAA standards.

Requirements

• Must be based in the United States.
• High school diploma required; Associate's or Bachelor's degree in healthcare administration or related field preferred.
• 1+ years of experience in healthcare administration, health plans, or provider services (managed care/TPA preferred).
• Proficiency in Microsoft Office (Outlook, Word, Excel).
• Excellent verbal and written communication skills for conveying complex technical information.
• Ability to work independently and problem-solve utilizing available resources.

Nice to have

• Experience with the Availity platform.
• Proficiency in SharePoint and Smartsheet with data analytics capabilities.
• Higher education degree.

Culture & Benefits

• Comprehensive medical and dental benefits effective from day one.
• Non-negotiable Paid Time Off (PTO) for rest and recharge.
• Mental health support, retirement planning, and financial protection.
• Professional development opportunities with learning budgets and clear career progression.
• Mission-driven culture emphasizing diversity, equity, and inclusion.