Provider Network Manager

Provider Relations Manager

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Verda Health Plan of Texas has a contract with CMS and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy.

We are looking for a Provider Relations Manager to join our growing company with many internal opportunities.

Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare, Inc. is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value‑based health care that works. We value diversity.

Position Overview

The Provider Relations Manager at Verda Healthcare plays a key role in building, maintaining, and enhancing strong relationships with Independent Physician Associations (IPAs), hospitals, and other contracted provider groups. This position serves as the provider‑facing contact responsible for delivering high‑quality service and support to Verda’s contracted provider network, ensuring providers are supported through effective communication, onboarding, issue resolution, and performance monitoring that enhance the provider and patient experience.

You will execute network strategies, driving initiatives, reporting progress to leadership. This role will serve as a key liaison between provider partners and internal Verda departments, driving collaboration to meet regulatory, operational, and strategic objectives, while advancing network adequacy and ensuring a high level of provider satisfaction.

This position reports to the Senior Director of Provider Network as part of Verda Healthcare, Inc.

Responsibilities

• IPA & Hospital Relationship Management – Serve as primary relationship owner for assigned IPAs and hospital systems; conduct regular check‑ins and ensure contract compliance and performance.
• Provider Onboarding & Communications – Coordinate onboarding for new IPAs and providers; ensure timely delivery of materials, orientation sessions, and operational readiness.
• Provider Inquiries & Support – Serve as point of escalation for provider inquiries, resolving issues in collaboration with claims, utilization management, credentialing, and other internal teams.
• IPA Roster Management – Oversee roster submissions, validation, and updates; ensure timely and accurate provider data reporting to meet compliance and CMS requirements.
• Joint Operations Committees – Organize and facilitate quarterly IPA/hospital Joint Operations Committee meetings; driving consensus on performance priorities and follow‑up actions.
• Internal Liaison – Collaborate with internal stakeholders (claims, UM, credentialing, compliance, member services, IT, and finance) to enforce contract terms and regulatory requirements, including but not limited to resolve provider issues and streamline processes. Provide high‑level recommendations to enhance operational workflows and service delivery.
• Provider Events & Education – Plan, coordinate, and host provider meetings, trainings, and appreciation events to strengthen partnerships and improve engagement.
• Network Adequacy Monitoring – Review monthly IPA network adequacy reports. Work collaboratively with leadership to develop action plan for gaps in access and communicate network performance to IPAs, addressing network gaps and resolution.
• Reporting – Develop and maintain reporting frameworks to track progress and strategic initiatives and network performance.
• Growth and Development – Collaborate with Provider Network Operations leadership to identify growth opportunities, retention strategies, and outreach results.
• Provider Adds/Terms – Manage and process provider additions and terminations, coordinating with credentialing, contracting, and directory maintenance teams.
• Credentia…