We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

The Supervisor, Provider Network Relations provides first-line supervision of a nine-person team of Provider Relations Representatives (PRRs), TriWest's primary contact for TRICARE and VA network providers. Reports to the Manager, Provider Network Relations, and works under general supervision, applying policies and contractual standards independently. Escalates staffing, budget, policy exceptions, unresolved complaints, or media/congressional inquiries to the Manager.Oversees daily operations across corporate and remote sites, including training, performance monitoring, quality audits, and staff development. Ensures the team meets contractual response times, quality standards, and provider satisfaction targets under TRICARE and VA requirements. Navigates moderate complexity from the regulated federal healthcare environment, competing service levels, TRICARE Manual and VA CCN guidance interpretation, and balancing production with empathetic communication.Interfaces with the Manager, peer supervisors, and cross-functional partners in Claims, Operations, Credentialing, Customer Service, and Provider Data. Resolves escalated provider issues and occasionally engages Defense Health Agency (DHA) or VA representatives on contract inquiries. Regular and reliable attendance is required.

Education & Experience

Required:

• Bachelor's (BS/BA) Degree and four (4) years of varied and responsible experience with health care programs, or any combination of education and experience that provides an equivalent background, plus the following:
• At least two (2) years of increasingly responsible provider relations experience such as provider relations, education, or contracting
• Minimum of one (1) year supervisory/management experience or demonstrated leadership skills
• Working knowledge of TRICARE and/or VA Community Care Network (CCN) provider programs, including provider contracting, credentialing, claims, and reimbursement policies
• Working knowledge of federal healthcare contracting principles, HIPAA privacy and security requirements, and applicable TriWest policies and procedures governing provider interactions
• Demonstrated ability to apply established departmental guidelines, contract manuals, and standard operating procedures to resolve routine and complex provider issues, and to recognize when situations require escalation to management
• Must be a U.S. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation

Preferred:

• Three (3) years' experience in provider relations, provider contracting, or healthcare operations
• Prior experience in government healthcare delivery programs (TRICARE, VA, Medicare)
• Experience supervising remote or geographically distributed staff
• Familiarity with Availity, provider portal platforms, or comparable provider-facing self-service tools

Key Responsibilities

• Supervise a team of approximately nine Provider Relations Representatives in the efficient and effective resolution of issues, complaints, and questions related to the provider network, applying TRICARE Manual, VA CCN guidance, and TriWest standard operating procedures to ensure consistent and compliant responses.
• Train, coach, and oversee PRRs in all aspects of the role - conducting provider solutions meetings, resolving provider issues in collaboration with Claims and Operations, and reporting feedback to TRICARE and VA representatives within contractual response times. Monitor individual and team adherence to service level agreements and quality standards.
• Actively lead or participate in resolving escalated provider issues, including media inquiries, congressional correspondence, and Defense Health Agency or VA representative escalations within assigned timeframes. Exercise independent judgment in determining which issues require escalation to the Manager, Provider Network Relations.
• Collaborate closely with peer Supervisors and other TriWest departments to resolve cross-functional issues, identify process improvements, and escalate unresolved systemic issues to management.

• Demonstrate and maintain current knowledge of all TRICARE and VA programs, contracting, credentialing, reimbursement, and operational policies, and participate in all required training. Maintain strong working understanding of internal processes and teams impacting the provider network, including Claims, Operations, Credentialing, and Provider Data.
• Establish and maintain positive working relationships with internal stakeholders and external network providers, responding to provider inquiries with professionalism, empathy, and accuracy.
• Provide feedback to the Manager, Provider Network Relations on claims processing, referral and authorization, or other unfavorable trends identified from provider interactions, including recommendations for process or communication adjustments.
• Support and manage the maintenance of accurate provider contact records in the Provider Services data systems, ensuring data integrity and compliance with documentation standards.
• Review and submit feedback on draft provider educational materials. Develop job aids, work instructions, processes, and procedures to support PRR consistency and onboarding of new staff.
• Conduct and oversee provider education outreach campaigns, as needed, in coordination with the Provider Program Manager and Provider Education staff.

• Monitor team production, quality, attendance, and adherence to contractual response times. Produce regular reports and dashboards for the Manager, Provider Network Relations summarizing team performance against established metrics.
• Perform quality audits of PRR work to ensure staff are following established processes, communicating professionally, and responding timely. Provide constructive, documented feedback to support individual performance improvement.
• Engage in regular staff development activities, including at least monthly one-on-one meetings with each PRR and ongoing training aligned to contractual, regulatory, and operational changes.
• Provide mentoring, recognition, and coaching, and work collaboratively with PRRs to establish individual and team goals aligned with departmental objectives.
• Develop appropriate performance improvement plans, in collaboration with the Manager and Human Resources, when PRRs are not meeting performance expectations.
• Manage PRRs based in Phoenix and remotely. Monitor productivity, quality, and quantity of work performed by each staff person and the team as a whole.
• Lead or participate in work projects and groups as assigned by leadership, as well as other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Coaching / Training / Mentoring: Actively fosters the actions required for desired business outcomes through ongoing constructive feedback. Develops the skills and capabilities of PRR staff through structured training, regular one-on-one meetings, and documented performance feedback. Supports onboarding of new staff and ongoing skill development aligned with TRICARE and VA program changes.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts communication style to the audience; listens critically; collaborates effectively. Confident and composed communicator with providers, government representatives, and cross-functional partners. Able to translate contractual and policy requirements into clear, actionable guidance for staff and providers.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, Excel, Teams, TriWest Intranet, provider services data systems, provider portal platforms, and department-specific software applications.

Coping / Flexibility: Resiliency in adapting to evolving program requirements, shifting priorities, and diverse stakeholder expectations while maintaining composure and a solutions-oriented mindset.

Creativity / Innovation: Ability to develop practical solutions to recurring provider issues; views change as necessary and supports continuous improvement of team processes and provider communications.

Delegation Skills: Provides clear performance expectations for provider-facing work and ensures PRRs have adequate access to information, tools, and resources to complete assignments. Delegates casework appropriately across the team and monitors completion against contractual response times.

Empathy / Customer Service: Customer-focused behavior in all provider-facing interactions. Demonstrates a helping approach, including active listening, patience, respect, and empathy for provider concerns - particularly during escalated or high-sensitivity situations involving complaints or congressional inquiries.

Independent Thinking / Self-Initiative: Critical thinker with the ability to focus on what matters most to achieving team and contractual outcomes. Commitment to task to produce results without close direction and to identify the resources, partnerships, and tools needed to succeed.

Information Management: Ability to manage large amounts of complex provider, contract, and performance data easily, communicate clearly, and draw sound conclusions. Uses provider data, performance metrics, and trend analysis to inform team decisions and report outcomes to management. Maintains accuracy and confidentiality of sensitive information.

High Intensity Environment: Ability to perform effectively under pressure, managing multiple competing priorities, tight contractual timelines, and evolving program requirements while maintaining accuracy, professionalism, and composure.

Leadership: Successfully supervises a team of Provider Relations Representatives. Provides clear direction, sets performance expectations, and holds staff accountable. Models professional judgment and integrity while balancing production standards with high-quality provider interactions. Takes ownership of team results and escalates appropriately.

Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and contractual response times within a high-volume, high-stress environment. Balances direct provider support with team oversight, reporting, and development activities.

Organizational Skills: Ability to organize people and tasks, adjust to shifting priorities, and learn systems within time constraints and with available resources; detail-oriented. Manages the workflow of a high-volume, regulated operation with competing contractual deadlines.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes, policies, and provider feedback with sound judgment. Has a realistic understanding of relevant issues and identifies root causes of recurring provider concerns. Applies analytical judgment to determine when issues require escalation versus routine resolution.

Team-Building / Team Player: Influences the actions and opinions of team members and peers in a positive direction and builds group commitment to shared team and departmental goals. Fosters a collaborative environment across Phoenix-based and remote PRR staff. Partners constructively with peer Supervisors and cross-functional departments.

Working Conditions

Working Conditions:

• Works within a standard office environment; remote work eligible per TriWest telecommuting policy with periodic office attendance as needed.
• Favorable working conditions in a climate-controlled office space.
• Extensive computer work with long periods of sitting; moderate keyboarding and telephone use.
• Must be able to travel (locally or distant with overnight stays) a minimum of ten (10) percent and maximum of thirty-five (35) percent of the time to support remote PRR staff, provider engagement events, and training.
• Must be able to lift a minimum of 20 lbs.
• Must be able to work under stressful conditions associated with high-volume provider interactions, contractual deadlines, and escalated inquiries.
• Must be available to cover any work shift and, when required, extend hours to support escalated provider issues, contractual reporting cycles, or business needs.
• Regular and reliable attendance is required.

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $86, 000 to $96, 000 per year.

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.