Provider Network Specialist III

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Provider Network Specialist III based in United States.

This role plays a key part in strengthening provider networks and ensuring individuals have access to high-quality healthcare and support services.The position focuses on provider relationship management, network operations, and coordination efforts that improve service delivery across <communities.You> will collaborate with internal teams and external partners to maintain accurate provider information, resolve challenges, and support organizational goals.This opportunity is ideal for a detail-oriented professional who enjoys building partnerships and improving healthcare access.The role combines operational expertise, communication skills, and problem-solving abilities within a mission-driven <environment.You> will contribute to initiatives that help create stronger systems of care and better outcomes for individuals and families.

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.