Job Openings Sr Provider Relations Consultant-Boston/MA -

About the job Sr Provider Relations Consultant-Boston/MA -


  1. Be a resident of Massachusetts.
  2. Previous experience in MA Provider Relations.
  3. Ability to travel to provider offices and hospitals in MA (50% travel, remainder work from home).
  4. Valid driver's license.
  5. Previous healthcare industry experience.

Job Description:

Join our client, a leading regional health insurance company with a 25-year history, as they expand their team. Enjoy a guaranteed $5000 sign-on bonus and contribute to the growth.

Our Investment in You:

  • Full-time remote work
  • Competitive salaries
  • Excellent benefits

Key Functions/Responsibilities:

  • Develop and enhance relationships with physicians, clinicians, community health centers, and hospitals.
  • Collaborate with Provider Relations Consultants and Supervisor for effective business interactions.
  • Lead specific Plan initiatives related to provider education.
  • Conduct provider orientations and training programs.
  • Act as a liaison between the Plan and key provider organizations.
  • Manage assigned territory and provider network partnerships.
  • Resolve complex contractual and member/provider issues.
  • Collaborate with internal departments for issue resolution.
  • Monitor and communicate market trends and issues.
  • Represent Provider Relations and the plan at external events.
  • Participate in community outreach activities and events.
  • Ensure quality and compliance with state Medicaid regulations and NCQA requirements.


  • Education: BA/BS required or related field, or equivalent combination of education and experience.
  • Experience: 4 or more years of progressively responsible experience in provider relations or network management required. Experience in the Medicare provider healthcare insurance industry preferred.
  • Certification or Conditions of Employment: Must have a valid drivers license and access to reliable transportation.

Competencies, Skills, and Attributes:

  • Knowledge or familiarity with Medicaid and Medicare.
  • Understanding of the local provider community.
  • Effective communication skills (verbal and written).
  • Strong analytical, research, and organizational skills.
  • Ability to establish and maintain relationships with internal and external constituents.
  • Strong follow-up skills.
  • Ability to work independently and manage multiple tasks.
  • Competence using Microsoft Office products, especially Excel and Access; familiarity with FACETS helpful.

Working Conditions and Physical Effort:

  • Must be willing to travel significantly to local communities (up to 50% of the time).
  • Ability to work in a fast-paced environment.

About Our Client:

Our client,  is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997,  provides high-quality health plans and services that work for its members, regardless of their circumstances.