Medical Network Provider Relations Manager

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry’s first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we’re deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

Location:Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area)

Position Summary

The Medical Network Provider Relations Manager is responsible for developing, managing, and strengthening relationships with healthcare providers, provider groups, facilities, and network partners. This role serves as the primary liaison between providers and the organization, ensuring provider satisfaction, network performance, contract compliance, and issue resolution. The Provider Relations Manager works closely with Network Development, Contracting, Claims, Operations, and Client Services teams to support provider engagement, optimize network performance, and drive strategic growth initiatives.

Position Responsibilities:

Provider Relationship Management

• Build and maintain strong relationships with healthcare providers, physician groups, hospitals, ancillary providers, and network partners.
• Serve as the primary point of contact for providers regarding operational, contractual, and service-related matters.
• Conduct regular provider outreach, meetings, and educational sessions to promote engagement and satisfaction.
• Develop and execute provider engagement strategies that support network growth and retention.

Provider Support and Issue Resolution

• Manage and resolve provider inquiries related to claims, reimbursement, network participation, credentialing, and operational processes.
• Collaborate with internal departments to investigate and resolve provider escalations in a timely manner.
• Monitor provider satisfaction trends and proactively address concerns.
• Ensure providers receive accurate and timely information regarding policies, procedures, and network requirements.

Network Management and Development

• Support provider recruitment, onboarding, and retention initiatives.
• Partner with Contracting and Network Development teams to identify network gaps and expansion opportunities.
• Assist with implementation of provider contracts and network participation agreements.
• Monitor provider performance and participation to ensure network adequacy and service excellence.

Provider Education and Communication

• Develop and deliver provider education programs regarding claims submission, reimbursement methodologies, policies, and operational processes.
• Communicate organizational updates, policy changes, and regulatory requirements to participating providers.
• Create and distribute provider newsletters, training materials, and communication resources.
• Facilitate provider meetings, webinars, and network forums.

Performance Analysis and Reporting

• Analyze provider performance metrics, service trends, and network utilization data.
• Develop reports and presentations for leadership regarding provider network performance and relationship management activities.
• Monitor key performance indicators (KPIs) such as provider satisfaction, issue resolution, and retention rates.
• Identify opportunities for process improvements and operational efficiencies.

Cross-Functional Collaboration

• Collaborate with Claims, Contracting, Credentialing, Provider Data Management, Operations, and Client Services teams.
• Act as a provider advocate within the organization to ensure provider perspectives are considered in decision-making.
• Participate in client meetings and strategic initiatives involving provider network management.
• Support implementations, acquisitions, network expansions, and special projects.

Compliance and Quality Assurance

• Ensure provider interactions a…