Note: The job is a remote job and is open to candidates in USA. Sigma, Inc. is a trusted staffing agency specializing in placing highly skilled professionals in healthcare, pharmaceutical, and medical device industries. They are currently recruiting a Provider Account Liaison to serve as the primary point of contact between provider groups and the health plan, focusing on developing relationships, supporting education, and improving operational efficiency.
Responsibilities
- Serve as the primary liaison between assigned healthcare providers and the organization
- Develop and maintain strong relationships with physician groups, medical practices, and provider organizations
- Conduct provider meetings, outreach activities, education sessions, and ongoing communications
- Identify provider challenges and proactively coordinate solutions
- Represent the organization at provider meetings, industry events, and collaborative sessions
- Support provider network strategies, contracting initiatives, and operational programs
- Educate providers on healthcare policies, reimbursement updates, technology changes, and operational processes
- Communicate updates related to Medicaid, Medicare Advantage, CMS requirements, and health plan procedures
- Assist providers with understanding organizational policies, programs, and compliance expectations
- Identify provider concerns and coordinate resolution with internal operational teams
- Partner with clinical, administrative, reimbursement, and project teams to improve provider experience
- Act as a communication bridge between provider groups and internal stakeholders
- Gather provider feedback and contribute recommendations for process improvements
- Support healthcare initiatives focused on improving quality outcomes, reducing costs, and enhancing member satisfaction
- Utilize reports, analytics, and available tools to monitor provider performance and program effectiveness
- Participate in projects related to provider operations, healthcare delivery, reimbursement models, and network initiatives
- Manage multiple priorities while meeting deadlines and organizational goals
- Ensure provider activities comply with CMS, Medicaid, HIPAA, and organizational requirements
- Maintain accurate documentation of provider interactions, communications, and issue resolutions
- Follow established policies, procedures, and quality standards
- Perform additional responsibilities as assigned to support provider network operations and healthcare initiatives
Skills
- Bachelor's degree in Business, Healthcare Administration, or related field preferred; equivalent healthcare experience considered
- Minimum 3–5+ years of experience in healthcare, health insurance, managed care, Medicaid, Medicare, or provider relations
- Experience working with provider networks, physician practices, healthcare organizations, or managed care organizations
- Understanding of healthcare delivery models, reimbursement methodologies, and insurance operations
- Strong provider relationship management and communication skills
- Experience conducting presentations, provider education, or stakeholder meetings
- Strong written and verbal communication abilities
- Excellent problem-solving, negotiation, and conflict-resolution skills
- Ability to manage multiple projects, priorities, and deadlines
- Knowledge of CMS regulations, Medicaid/Medicare requirements, and HIPAA compliance
- Proficiency with Microsoft Office applications including Word, Excel, and PowerPoint
- Ability to work independently in a fully remote environment
- Must be a US Citizen
- Must reside in Delaware (DE)
- Experience working with Medicaid Managed Care Organizations (MCOs)
- Provider contracting or network development experience
- Project management experience
- Experience presenting healthcare concepts to different audiences
- Knowledge of value-based care, reimbursement models, quality improvement initiatives, or healthcare analytics
Benefits
- Access contract-to-hire opportunities with leading healthcare organizations.
- Opportunity to transition into a long-term career role.
- Work on impactful healthcare initiatives supporting provider and member outcomes.
- Gain exposure to healthcare operations, provider networks, and managed care programs.
- Receive professional support throughout the hiring process.
Company Overview