DATE: October 22, 2026
POSITION: Provider Relations Representative
DEPARTMENT: Operations - Provider Operations
RATE: $22.46 per hour, with potential for additional compensation based upon qualifications
POSITION SUMMARY:
This position serves as a provider-facing resource for practitioners, providers, facilities, and provider offices participating in the Upper Peninsula Managed Care (UPMC) network. The Provider Relations Representative fosters positive relationships through education, communication, outreach, and engagement activities.
This position also supports network adequacy, accessibility, regulatory compliance, and initiatives strengthening provider engagement and improving access to care.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information.
2. Serves as a liaison between UPHP and participating provider offices to promote positive provider relationships and effective communication. Provides general support to providers seeking assistance through phone, email, mail, fax, or other communication channels.
3. Assists provider offices in navigating UPHP processes and identifying the appropriate department or resource to address operational questions or concerns. Provides education to providers and provider office staff regarding UPHP resources, programs, self-service tools, policies, and procedures.
4. Responds to provider relationship concerns and collaborates with internal and external stakeholders to support timely resolution and positive provider experiences.
5. Assists with provider onboarding and orientation activities, ensuring providers are informed of available resources, educational materials, and key organizational contacts.
6. Develops, coordinates, and facilitates distribution of provider communications, including provider newsletters, announcements, educational materials, and other provider-facing communications.
7. Assists in the planning, coordination, and implementation of provider engagement activities, including provider meetings, educational webinars, in-services, and outreach initiatives.
8. Coordinates and conducts provider office outreach activities and site visits in accordance with departmental policies and procedures and maintains related documentation. Responsible for the execution, reporting, and file maintenance of site visit surveys.
9. Serves as the liaison between provider offices and commercial companies that use the UPMC network. Responds to provider questions about commercial companies and works with those companies to investigate and resolve discrepancies in provider file information.
10. Facilitates provider information updates and advocates for providers by coordinating systems-related support with commercial network partners.
11. Supports processes to ensure network provider data is accurate and inputs provider and group contract information into the credentialing system; works with configuration staff to ensure accurate provider data is loaded into the claims processing system.
12. Provides support to other departments through verification of provider data, problem solving with provider offices, assisting and finalizing provider communication documents, and responding to access and availability provider related concerns and potential leads.
13. Assists in compliance reporting to the Michigan Department of Health and Human Services (MDHHS) related to contracting, network adequacy and access, provider directory data, and provider network related policies.
14. Assists in ensuring compliance with state, federal, and accrediting agencies’ network adequacy standards. Augments and modifies the provider network as needed to comply with applicable network adequacy standards, including those standards set forth by the Centers for Medicare and Medicaid Services (CMS).
15. Performs other related duties as assigned or requested.
POSITION QUALIFICATIONS:
Education:
Minimum:
Associate degree in business, office information services, health information processing,
computer information systems, or related field
Preferred:
Bachelor’s degree in communications, public relations, business administration, or related field
Experience:
Minimum:
One (1) to two (2) years of experience in health-care operations, provider relations, or customer
service
Preferred:
Three (3) to four (4) years of customer relations experience in a health-care setting and/or a
business background in health care; prior contracting experience
Required Skills:
Working knowledge of MS Office (Word, Excel, and PowerPoint)
Excellent human relation and oral/written communication
Excellent organizational and prioritization abilities with attention to detail
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards but as general guidelines that should be considered along with other job-related selection or promotional criteria.
Physical Requirements:
[This job requires the ability to perform the essential functions contained in the description. These include, but are not limited to, the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]:
Ability to enter and access information from a computer
Ability to access all areas of the UPHP offices
Occasionally lifts supplies/equipment
Prolonged periods of sitting
Manual dexterity
Working Conditions:
Works in office conditions, but occasional travel may be required
Exposure to situations requiring exceptional interpersonal skills or periods of intense concentration
Subject to many interruptions
Occasionally subjected to irregular hours
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