Provider Network Specialist III
New
J
JobgetherHealthcare Administration
Remote work opportunity within North Carolina.Full-TimeSenior
Salary68,890 - 92,138 USD per year
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Job Details
- Required Skills
- Data AnalysisCompliance
Requirements
- Experience working in healthcare administration, managed care, provider relations, network management, or a related field.
- Strong understanding of provider network operations, healthcare systems, and managed care processes.
- Experience managing provider relationships and collaborating with healthcare professionals, organizations, and internal stakeholders.
- Ability to analyze data, identify operational challenges, and recommend effective solutions.
- Strong organizational skills with the ability to manage multiple priorities, deadlines, and projects.
- Excellent written and verbal communication skills with the ability to communicate effectively with diverse audiences.
- Strong attention to detail and ability to maintain accurate records and documentation.
- Ability to work independently while collaborating effectively in a remote environment.
- Experience with healthcare compliance requirements, provider contracts, or credentialing processes is preferred.
- Knowledge of behavioral health, substance use services, intellectual/developmental disabilities, or related healthcare programs is a plus.
Responsibilities
- Manage provider network activities, including provider onboarding, maintenance, communication, and ongoing relationship support.
- Serve as a primary point of contact for assigned providers, addressing inquiries, resolving issues, and ensuring effective collaboration.
- Review and maintain provider records, contracts, and network documentation to ensure accuracy and compliance.
- Coordinate with internal departments to support provider operations, credentialing processes, and network improvement initiatives.
- Analyze provider network data, identify trends, and provide recommendations to improve access, quality, and operational performance.
- Support the implementation of network strategies that align with healthcare service needs and organizational objectives.
- Assist with provider education, communication campaigns, and updates related to policies, procedures, and operational changes.
- Monitor provider performance, compliance requirements, and service delivery standards while escalating issues when necessary.
- Participate in audits, reporting activities, and process improvement efforts related to provider network management.
- Build strong partnerships with providers and stakeholders to support effective healthcare delivery across the service area.
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