How to hire a provider relations specialist

How to hire a provider relations specialist, step by step

Here's a step-by-step provider relations specialist hiring guide:

• Step 1: Identify your hiring needs
• Step 2: Create an ideal candidate profile
• Step 3: Make a budget
• Step 4: Write a provider relations specialist job description
• Step 5: Post your job
• Step 6: Interview candidates
• Step 7: Send a job offer and onboard your new provider relations specialist
• Step 8: Go through the hiring process checklist

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1. Identify your hiring needs

   First, determine the employments status of the provider relations specialist you need to hire. Certain provider relations specialist roles might require a full-time employee, whereas others can be done by part-time workers or contractors.

   Determine employee vs contractor status

   Is the person you're thinking of hiring a US citizen or green card holder?

   Yes

   No

   Hiring the perfect provider relations specialist also involves considering the ideal background you'd like them to have. Depending on what industry or field they have experience in, they'll bring different skills to the job. It's also important to consider what levels of seniority and education the job requires and what kind of salary such a candidate would likely demand.

   Here's a comparison of provider relations specialist salaries for various roles:

   Type of Provider Relations Specialist	Description	Hourly rate
   Provider Relations Specialist	Customer service representatives interact with customers to handle complaints, process orders, and provide information about an organization’s products and services.	$14-31
   Provider Services Representative	A provider services representative is responsible for supporting, developing, and maintaining service relationships with involved participants, including providers, physicians, and administrators. Your duties typically include responding to direct and electronic questions from clients about rates, policies, referrals, and eligibility, handling telephone calls for the provider and member inquiries, and resolving complaints by the member and member representative... Show more	$11-22
   Provider Relations Representative	Provider relations specialists are professionals who work for insurance companies as the primary contact for health care providers such as clinics and hospitals. These specialists are required to provide answers about service contracts and billing procedures to health care providers... Show more	$14-26

2. Create an ideal candidate profile

   Common skills:

   • Provider Relations
   • Medicaid
   • Health Plan
   • Orientation Materials
   • Issue Resolution
   • Claims Submission
   • EDI
   • Claims Processing
   • Customer Service
   • Phone Calls
   • Network Development
   • Medicare Advantage
   • Provider Contracts
   • Medical Terminology

   Check all skills

   Responsibilities:

   • Design short and long term plans for PCPs to accomplish suggest benchmarks and growth of its membership.
   • Provide keen oversight in developing and maintaining quality improvement programs while managing payroll.
   • Organize and analyze CMS changes for distribution to the team.
   • Meet or exceed productivity and quality goals base on CMS guidelines/directives.
   • Establish and maintain positive and productive relations with network providers for Medicaid and Medicare.
   • Assist in IPA profitability through the recruitment and contracting of key physicians, hospitals and ancillary organizations with target membership panels.

3. Make a budget

   Including a salary range in your provider relations specialist job description is one of the best ways to attract top talent. A provider relations specialist can vary based on:

   • Location. For example, provider relations specialists' average salary in mississippi is 55% less than in massachusetts.
   • Seniority. Entry-level provider relations specialists 54% less than senior-level provider relations specialists.
   • Certifications. A provider relations specialist with certifications usually earns a higher salary.
   • Company. Working for an established firm or a new start-up company can make a big difference in a provider relations specialist's salary.

   Average provider relations specialist salary

   $44,403yearly

   $21.35 hourly rate

   ---

   Entry-level provider relations specialist salary

   $30,000 yearly salary

   Updated December 24, 2025

4. Writing a provider relations specialist job description

   A job description for a provider relations specialist role includes a summary of the job's main responsibilities, required skills, and preferred background experience. Including a salary range can also go a long way in attracting more candidates to apply, and showing the first name of the hiring manager can also make applicants more comfortable. As an example, here's a provider relations specialist job description:

   Provider relations specialist job description example

   The Provider Relations/Engagement Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
   Responsibilities
   
   The Provider Relations/Engagement Professional 2 will be responsible for:
   
   Visiting w/Provider face to face and virtual, educating providers on policies and processes, building relationships, educating providers on the use of online tools and resources, monitoring reports and documenting provider encounters Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Must be passionate about contributing to an organization focused on continuously improving consumer experiences Follows established guidelines/procedures.
   
   Required Qualifications
   1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies Demonstrated ability to manage multiple projects and meet deadlines Intermediate to advanced computer skills and experience with Microsoft Word, Excel, Outlook and Power PointStrong verbal and written communication skills Strong organization and prioritization skills Experience working with Providers Office, Hospitals, Conferences, Seminars, Town Halls and other community based events Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Must be available to work a flexible schedule for Association Events otherwise the schedule will be Monday - Friday and require a minimum of 3-4 days travel a week in your local area Training date 10/10/22
   
   Work-At-Home Requirements
   
   Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role.A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
   
   Travel
   This position will require a minimum of 3-4 days a week in your local area - New Orleans and Baton Rouge areas Must have a Valid driver's license with reliable transportation and the ability to travel within the state, as required This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
   
   Preferred Qualifications
   Experience with Physical or Behavioral HealthWorking with Louisiana MedicaidComprehensive knowledge of Medicaid policies, processes, and procedures
   
   Additional Information
   
   Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)
   
   #LI-KK1 #LouisianaMedicai
   
   Scheduled Weekly Hours
   
   40

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5. Post your job

   To find provider relations specialists for your business, try out a few different recruiting strategies:

   • Consider internal talent. One of the most important talent pools for any company is its current employees.
   • Ask for referrals. Reach out to friends, family members, and your current work to ask if they know any provider relations specialists they would recommend.
   • Recruit at local colleges. Attend job fairs at local colleges to recruit entry-level provider relations specialists with the right educational background.
   • Social media platforms. LinkedIn, Facebook, and Twitter have more than 3.5 billion users, and they're a great place for company branding and reaching potential job candidates.

   Post your job online:

   • Post your provider relations specialist job on Zippia to find and recruit provider relations specialist candidates who meet your exact specifications.
   • Use field-specific websites.
   • Post a job on free websites.

6. Interview candidates

   Your first interview with provider relations specialist candidates should focus on their interest in the role and background experience. As the hiring process goes on, you can learn more about how they'd fit into the company culture in later rounds of interviews.

   It's also good to ask about candidates' unique skills and talents. You can move on to the technical interview if a candidate is good enough for the next step.

   The right interview questions can help you assess a candidate's hard skills, behavioral intelligence, and soft skills.

7. Send a job offer and onboard your new provider relations specialist

   Once you've decided on a perfect provider relations specialist candidate, it's time to write an offer letter. In addition to salary, it should include benefits and perks available to the employee. Qualified candidates may be considered for other positions, so make sure your offer is competitive. Candidates may wish to negotiate. Once you've settled on the details, formalize your agreement with a contract.

   It's equally important to follow up with applicants who don't get the job with an email letting them know that the position has been filled.

   After that, you can create an onboarding schedule for a new provider relations specialist. Human Resources and the hiring manager should complete Employee Action Forms. Human Resources should also ensure that onboarding paperwork is completed, including I-9s, benefits enrollment, federal and state tax forms, etc., and that new employee files are created.

8. Go through the hiring process checklist

   • Determine employee type (full-time, part-time, contractor, etc.)
   • Submit a job requisition form to the HR department
   • Define job responsibilities and requirements
   • Establish budget and timeline
   • Determine hiring decision makers for the role
   • Write job description
   • Post job on job boards, company website, etc.
   • Promote the job internally
   • Process applications through applicant tracking system
   • Review resumes and cover letters
   • Shortlist candidates for screening
   • Hold phone/virtual interview screening with first round of candidates
   • Conduct in-person interviews with top candidates from first round
   • Score candidates based on weighted criteria (e.g., experience, education, background, cultural fit, skill set, etc.)
   • Conduct background checks on top candidates
   • Check references of top candidates
   • Consult with HR and hiring decision makers on job offer specifics
   • Extend offer to top candidate(s)
   • Receive formal job offer acceptance and signed employment contract
   • Inform other candidates that the position has been filled
   • Set and communicate onboarding schedule to new hire(s)
   • Complete new hire paperwork (i9, benefits enrollment, tax forms, etc.)

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