Provider Network Specialist

This is a fully remote position, open to applicants in Oregon, +1 more state.

📋 Description

• Analyze provider demographic data, financial information, quality reports, and special project data.

• Assist the performance team in the preparation and execution of monthly provider performance meetings.

• Perform comprehensive audits across provider performance systems, including Orinoco, online search tools, print directories, Looker reports, and claims payment processes.

• Assess data to identify gaps, inefficiencies, and root causes that affect provider performance.

• Provide actionable insights and collaborate with the performance team to implement enhancements.

• Interact directly with providers to address provider-related issues, ensuring prompt resolution and documentation.

• Oversee the complete contract lifecycle.

• Facilitate the onboarding of high-performing providers and enhance overall engagement.

• Collaborate with Performance Managers in preparation for monthly performance meetings.

• Extract data using AI-driven prompts and advanced AI tools.

• Create slide decks and follow up on items from previous meetings.

⛳️ Requirements

• Must reside in Washington or Oregon.

• At least 3 years of experience in healthcare, preferably within Medicare Advantage or similar settings.

• 5 years of experience in direct provider interaction.

• Proven ability to manage detailed, performance-oriented tasks.

• Proficiency in Google or MS Suite Workspace applications.

• Experience in claims research, provider setup, root cause analysis, and process improvement with a focus on provider engagement.

• Excellent written and verbal communication skills.

• Highly organized and detail-oriented.

• Ability to effectively manage competing priorities and adapt to ambiguity is essential.

• Capacity to gather, read, analyze, and interpret complex data, creating accurate and meaningful information for data reporting.

• Skill in facilitating meetings and delivering presentations to groups of management and staff.

🏝️ Benefits

• Employer-sponsored health, dental, and vision plan with low or no premium.

• Generous paid time off.

• $100 monthly stipend for mobile or internet expenses.

• Stock options available for all employees.

• Bonus eligibility for all positions except Director and above.

• Commission eligibility for Sales roles.

• Parental leave program.

• 401K program.