Senior Network Specialist, Southeast Region

2+ years of experience in provider network operations, contracting or provider services. 1+ years of experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry. 1+ years of experience navigating and organizing large data sets such as claim files and provider rosters. Associate's degree or equivalent professional working experience (Bonus).

Negotiate contracts with healthcare providers for favorable terms and compliance. Analyze provider contracts to identify improvement areas. Use data and analytics for negotiation and contracting decisions. Support implementation of contracting policies and workflows. Monitor and analyze network performance, cost, and provider satisfaction metrics. Resolve provider issues professionally and timely. Build and maintain positive relationships with healthcare providers. Track and analyze key performance indicators for provider satisfaction and efficiency. Support provider onboarding, training, and resource distribution. Collaborate with internal teams to resolve provider issues. Participate in process improvement initiatives. Ensure compliance with all applicable laws and regulations.