Provider Relationship Manager - Austin

Harbor Health • Austin, TX

1d

About The Position

At Harbor Health, we’re transforming healthcare in Texas through collaboration and innovation. We’re seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you’re ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!

The Provider Relationship Manager serves as the “boots on the ground” representative of the health plan for all in-network provider groups across the region. This role is responsible for ensuring an exceptional member experience by building strong provider relationships, resolving operational issues, improving network performance, and aligning provider groups with the health plan’s strategic objectives.

The Provider Relationship Manager acts as the primary point of contact for in-network practices and works cross-functionally with contracting, claims, credentialing, care management, and member services to proactively remove friction and drive measurable network performance improvements.

This is a highly visible, field-based role that blends provider relations, operational problem-solving, and performance management.

Requirements

• 5+ years experience in:
• Provider relations
• Network operations
• Practice management
• Health plan operations
• Strong understanding of:
• Claims processing
• Authorizations
• Credentialing
• Network adequacy
• Value-based reimbursement models
• Experience working directly with physician groups and MSOs.
• Excellent communication and conflict-resolution skills.
• Highly organized with ability to manage multiple provider relationships simultaneously.
• Willingness to travel regionally (50–70%).

Nice To Haves

• Experience in regional or startup health plans.
• Experience supporting CINs or value-based models.
• Data literacy (Excel, reporting dashboards, performance tracking).

Responsibilities

• Provider Relationship Management
• Serve as the primary relationship owner for assigned in-network provider groups
• Conduct regular in-person and virtual visits with practices.
• Build trust-based partnerships with physicians, practice managers, and administrative leadership.
• Represent the health plan in a professional, responsive, and solutions-oriented manner.
• Member Experience Optimization
• Ensure providers understand plan benefits, referral pathways, authorization requirements, and network structure.
• Identify and resolve issues that negatively impact member access, scheduling, billing, or care coordination.
• Monitor complaints, grievances, and service trends tied to assigned groups.
• Proactively intervene to prevent network friction before it impacts members.
• Operational Issue Resolution
• Troubleshoot and resolve claims, eligibility, prior authorization, and billing concerns.
• Partner with internal teams to escalate and close provider issues quickly.
• Track and trend recurring operational problems and recommend system improvements.
• Support clean claims performance and administrative simplification.
• Network Performance & Accountability
• Review provider-level performance metrics (access, quality, cost, utilization).
• Support implementation of value-based initiatives and performance programs.
• Educate providers on quality measures, documentation, and coding best practices.
• Assist with corrective action plans when needed.
• Network Growth & Retention
• Support onboarding of newly contracted provider groups.
• Ensure smooth implementation and readiness before go-live.
• Monitor provider satisfaction and mitigate termination risk.
• Provide field intelligence on competitive dynamics and provider market trends.
• Cross-Functional Collaboration
• Partner with: Network Contracting Claims Operations Care Management Utilization Management Member Services Credentialing
• Serve as the feedback loop between the provider community and internal leadership.

Benefits

• A collaborative and innovative work environment committed to member-centered care.
• An organization passionate about improving healthcare delivery in Austin and beyond.
• Competitive salary and comprehensive benefits package.
• Professional development and opportunities for career growth.
• A transparent, supportive, and inclusive culture that values every team member’s contributions.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed