Under the general supervision, the Provider Relations Specialist interfaces with providers and internal/external stakeholders to resolve escalated situations, monitor complaint investigations, and ensure thorough and timely follow-through. The Provider Relations Specialist audits provider files to ensure compliance with state and agency regulations, while maintaining accurate, confidential records and responding to inquiries from DPSS, CDSS, CCL, and fraud investigators. Acting as a liaison with Community Care Licensing, internal departments, and external partners, this role coordinates effective responses to complaints and investigations. This role reviews processes and decision letters to ensure accuracy and regulatory alignment. This role provides clear technical assistance and customer service to providers regarding the complaint process, their rights, and responsibilities. To strengthen organizational capacity, this role develops and delivers internal and external training, creates standard operating procedures, and identifies staff training needs with recommended improvements. This full-time position offers a hybrid work environment that includes in-office, remote, and community-based responsibilities.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
501-1,000 employees