Provider Network Specialist III

Accountabilities:
As a Provider Network Specialist III, you will support provider network operations by managing relationships, ensuring compliance, and improving network effectiveness. 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. Requirements: The ideal candidate brings experience in provider network operations, healthcare administration, and relationship management, along with strong analytical and communication skills. 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. Benefits: Salary range of $68,890 - $92,138. Remote work opportunity within North Carolina. Opportunity to support meaningful healthcare programs that improve access and outcomes for individuals and families. Collaborative and mission-driven work environment. Professional development and career growth opportunities. Comprehensive employee benefits package, including healthcare and wellness support. Opportunity to contribute to innovative approaches in managed care and provider network improvement.

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