Provider Relations Specialist Job at Carisk Partners, Miami, FL

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  • Carisk Partners
  • Miami, FL

Job Description

:

Remote

Company Overview:

Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and other managed care organizations. Through its Pathways 2 Recovery care model, Carisk Partners aims to improve outcomes and reduce overall cost of quality care by applying best practices in a patient - centered approach to manage complex challenges for the group health, casualty and auto markets.

Role Overview:

The Provider Relations Specialist serves as a key liaison between Carisk Partners and the provider community, helping to expand and strengthen our provider network to support injured workers. Carisk Partners operates within the Workers' Compensation industry and encompasses multiple divisions, including HeadsUp Healthcare and Carisk Outcomes.

This role primarily supports the HeadsUp Healthcare division by identifying, sourcing, and contracting with behavioral health providers - both individual clinicians and group practices - to ensure injured workers have timely access to high-quality care. As the main point of contact for providers, the Provider Relations Specialist will foster lasting relationships through clear communication, education, and ongoing support.

When needed, the Provider Relations Specialist will also support Carisk Outcomes by coordinating with a broader range of healthcare providers involved in the injured worker's care, including both physical health and behavioral health providers.

This role is key to the day-to-day management and growth of our provider network, with responsibilities spanning recruitment, contracting, retention, education, issue resolution, and the cultivation of strong provider relationships.

Role Responsibilities:

  • Manage assigned provider sourcing requests, ensuring providers align with the client expectations, and meet injured worker's clinical, geographic, and logistical needs.
  • Conduct thorough research using available tools to identify, evaluate, and engage appropriate behavioral health providers.
  • Lead contracting and negotiation efforts with providers, including the preparation and execution of agreements and amendments, in alignment with company standards.
  • Consistently meet or exceed recruitment goals within established timelines to support the timely delivery of care for injured workers.
  • Provide timely updates to internal stakeholders, including sourcing status reports and escalation of any issues that may delay access to care.
  • Identify gaps in the provider network based on geography or specialty and proactively recruit new providers to address those needs.
  • Serve as the primary point of contact for providers, clearly communicating operational procedures, referral processes and expectations, while reinforcing the value of partnering with HeadsUp Healthcare and, when applicable, Carisk Outcomes.
  • Address provider concerns and complaints by coordinating with internal teams to ensure timely and satisfactory resolution.
  • Act as a liaison between providers and internal departments, including Billing, Scheduling, Care Management, and Sales/Marketing, to support seamless operations.
  • Build and maintain strong, collaborative relationships with providers to support engagement, retention, and compliance.
  • This outlines the core responsibilities and expectations for the role, but is not all-inclusive. Duties may evolve based on business needs, and additional responsibilities may be assigned as required.

Role Qualifications:

  • Bachelor's degree in Healthcare, Business or related field (equivalent industry experience may be considered in place of a degree).
  • Minimum of 2 years of experience in provider recruitment, contracting, and negotiation.
  • Solid understanding of managed care principles and reimbursement methodologies.
  • Ability to work independently, manage time effectively, and set clear priorities.
  • Proven experience building and maintaining strong relationships within the provider community.
  • Collaborative team player with the ability to thrive in a fast-paced environment and develop positive working relationships across departments.
  • Highly organized and customer-focused, with excellent interpersonal skills and the ability to effectively engage and influence providers.
  • Strong written and verbal communication skills; experience delivering formal presentations is a plus.
  • Proficient in Microsoft Office, especially Excel.
  • Experience in Workers' Compensation and/or behavioral health is preferred.
  • Access to a personal vehicle and a valid driver's license is preferred.
  • Willingness to travel within assigned geographic territory, as needed.

Culture and Benefits at Carisk:

  • 10 Paid Company Holidays
  • Paid Time Off
  • Competitive Medical, Dental, and Vision Insurance
  • Company Sponsored Life Insurance
  • Supplemental Life Insurance, Short/Long Term Disability, Employee Assistance Program, Flexible Spending Account, and many other Ancillary Benefits
  • 401(k) Retirement Plan with Company Match
  • Employee Discount Program
  • Flexible and Hybrid Schedule Options*
  • Internal Education Programs and Tuition Reimbursement Options
  • Internal Advancement Opportunities
  • Company-Wide Diversity and Holiday Celebrations
  • Schedule options and work location vary between departments and management approval

Carisk Partners provides equal employment opportunities to all employees and applicants for employment, and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Tags

Full time, Temporary work, Work at office, Local area, Remote work, Flexible hours

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