Provider Relations Representative

We're Hiring: Provider Relations Representative (Remote)

If you’re looking for a role where your work directly impacts access to care and organizational growth, this is an opportunity to be part of something meaningful.

About Behavioral Innovations:

Since 2000, Behavioral Innovations (BI) has been a leading provider committed to transforming lives by providing compassionate, center-based Applied Behavioral Analysis (ABA) therapy for children with autism, ages 18 months to 10 years. With more than 100+ locations across six states (TX, OK, CO, VA, MD, NC) - and more to come - we’re continuing to expand rapidly. Join our dynamic team and make a meaningful difference in the lives of the families we serve.

Your Role and What You'll Do: 

We are seeking an Provider Relations Representative to manage and strengthen relationships with Managed Care Payors across the nation. This role plays an important part in ensuring our centers can deliver services efficiently by removing payor barriers, supporting contracting initiatives, and maintaining accurate provider network information. You will work closely with internal teams across operations, billing, credentialing, and contracting while serving as a key liaison with payor partners. This role is ideal for someone who understands the managed care landscape, knows how to navigate payor systems, and is comfortable resolving issues that impact authorizations, claims, and access to care.

As a Provider Relations Representative, you will work remotely, independently managing your responsibilities while collaborating with internal teams. This role reports directly to the Vice President of Payor Strategy & Contracting.

Responsibilities:

• Serve as a primary point of contact for Managed Care Payor relationships across BI markets.
• Lead and coordinate quarterly Joint Operating Committee (JOC) meetings with large Managed Care Payors and internal stakeholders.
• Manage the Single Case Agreement (SCA) process with non-participating payors allowing access to care.
• Support internal denial management with authorization, eligibility & benefits, and claims-related issues with Managed Care Payors.
• Review and maintain all Managed Care Provider directories for accuracy, coordinating updates with credentialing team.
• Audit newly executed contracts to confirm billing and reimbursement align with negotiated rates.
• Partner with internal teams to remove barriers that may delay or prevent patient admissions. 
• Coordinate, support and manage internal monthly delegated credentialing committee meetings, including audits with managed care payors.
• Submit and follow up on payor contract requests in existing and new markets, supporting expansion efforts and handoff to VP of Payor Strategy once approved for contracting.

Qualifications:

• Bachelor’s degree in business administration or a related field preferred.
• 5+ years of experience working with Managed Care Payors preferred.
• 5+ years of experience negotiating single case agreements with Managed Care Payors preferred.
• Strong understanding of Managed Care Payor hierarchy, including structures, contracting processes, and provider relations.
• Ability to work independently while collaborating across internal teams.
• Strong organizational skills and attention to detail.
• Strong relationship-building, communication skills, bias for action, strong business acumen and a team player.
• Proficiency with Microsoft Excel and Word.
• Experience in Applied Behavior Analysis (ABA) or behavioral health is a plus.

Why Join Behavioral Innovations?

• Compensation: $60,000 starting base salary, plus potential eligibility for a discretionary performance-based bonus.
• Comprehensive Benefits: Medical, Dental, Vision, and Supplemental Insurance.
• Work-life Balance: 15 days PTO, plus 7 Paid Holidays.
• Wellbeing & EAP Programs: Supporting your personal and professional wellness.
• Career Growth: Be part of an expanding organization that will double in size within 18 months, opening doors for professional advancement and leadership opportunities.
• Family-Centric Culture: Recognized for clinical excellence, integrity, and innovation.
• Mission-Driven Work: Transform the lives of children with autism while building a stronger future for yourself and your team.

• Recognized Industry Leader: Named Company of the Year in 2022, reflecting our continued growth and impact in the ABA field.

• National Recognition: Proudly ranked on the Inc. 5000 list as one of America’s Fastest Growing Private Companies — for 3 consecutive years!

Ready to Make an Impact?

If you want to play a role in expanding access to life-changing care while building strong payor partnerships, we’d like to hear from you.

Be a Provider Relations Representative at Behavioral Innovations.

Where Potential Thrives.