Provider Engagement Specialist

Texicare•Austin, TX

8d•Hybrid

About The Position

We are hiring a Provider Relations Specialist to assist with building strong, collaborative relationships across our provider network and delivering an exceptional provider experience. In this role, you will serve as a trusted point of contact for physicians, medical groups, hospitals, and ancillary providers—helping them navigate health plan processes, resolve operational issues, and stay informed on key updates and initiatives. You will play a hands-on role in provider education, onboarding, and engagement, while partnering closely with internal teams to support network operations, provider satisfaction, and network growth. This is an ideal opportunity for someone who enjoys relationship-building, problem-solving, and making a meaningful impact on how providers experience and interact with a health plan.

Requirements

A bachelor’s degree or any equivalent combination of education, training, and experience.
At least 2 years of experience in provider relations, network management, healthcare operations, or managed care or any equivalent combination of education, training, and experience.
An understanding of provider contracting, credentialing, claims workflows, and utilization management.
Strong relationship-building, communication, and presentation skills.
Demonstrated problem-solving and conflict-resolution abilities.
High attention to detail with strong organizational skills.
Proficiency in Microsoft Office Suite and familiarity with provider portals, CRM systems, and reporting dashboards.

Nice To Haves

Experience working with commercial health plans is strongly preferred.

Responsibilities

Provider Relationship Management
Build and maintain strong working relationships with physicians, medical groups, hospitals, and ancillary providers to deliver a best-in-class provider experience.
Serve as the providers’ primary point of contact; conduct regular outreach (virtual, telephonic, and in-person) to address operational issues, identify trends, and proactively resolve concerns.
Provider Education & Support
Deliver training, orientation, and ongoing education to network providers regarding credentialing, recredentialing, claims submission, authorization requirements, quality programs, and utilization management processes.
Communicate updates to network providers regarding policy changes, regulatory requirements, program enhancements, and new technology tools.
Ensure providers understand and can navigate provider portals, reporting dashboards, and self-service tools.
Network Operations & Issue Resolution
Support network development efforts, including provider onboarding, demographic accuracy, and participation in credentialing processes.
Identify gaps in provider knowledge or workflow inefficiencies and coordinate internal resources to drive resolution.
Track provider issues to completion and maintain detailed documentation in CRM or internal systems.
Provider Engagement & Outreach Activities
Plan and execute provider engagement activities, including webinars, office visits, training, and informational sessions.
Collect provider feedback and relay insights to internal stakeholders to inform process improvements and enhance the provider experience.
Support the administration and follow-up of annual provider satisfaction surveys and related improvement strategies.
Network Development and Contracting Support
Support provider recruitment and network expansion efforts by conducting outreach to prospective providers and communicating the company’s value proposition.
Partner with the contracting team to support network adequacy monitoring and expansion efforts for targeted provider outreach.