Provider Network Specialist – Senior

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Assist in managing provider network operations and help develop strategies that enhance clinical performance.

• Work collaboratively with cross-functional teams to assess provider requirements and analyze clinical and operational metrics.

• Ensure the network's adequacy, compliance, and efficient service delivery.

• Advise providers on quality standards, performance expectations, and opportunities for improvement.

• Utilize clinical knowledge to foster high-quality, person-centered care.

• Contribute clinical perspectives to activities related to network development and management that support provider performance and value-based care models.

• Tackle provider performance challenges, access issues, and network deficiencies through clinical evaluations, outreach, and coordinated problem-solving.

• Align clinical considerations with operational, regulatory, and organizational standards.

• Engage in continuous improvement efforts concerning provider performance, clinical results, network quality, and member access.

⛳️ Requirements

• Master’s degree.

• One (1) year of experience in a clinical environment with the MH/SU/IDD population.

• Active North Carolina licensure as a Licensed Clinical Social Worker (LCSW), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Marriage and Family Therapist (LMFT), Licensed Psychological Associate (LPA), or Registered Nurse (RN).

• Valid driver’s license.

• Must be a resident of North Carolina.

• Ability to travel within the catchment area as needed.

• All candidates are required to pass a drug test as a condition of employment.

• Preferred: Degree in a Human Services field.

• Preferred: Five (5) years of post-Master’s experience in a clinical setting with the MH/SU/IDD population.

• Preferred: Experience in administrative and operational roles in a clinical environment.

• Preferred: Certified Professional in Healthcare Quality (CPHQ), Lean Six Sigma Green Belt, and/or Project Management Professional (PMP) or an equivalent project management certification.

🏝️ Benefits

• A collaborative, mission-driven work environment.

• Competitive benefits.

• Work-from-home options available for most positions.

• Opportunities for professional advancement.

• A diverse and inclusive culture.

• Flexible work schedules available for select positions with management approval.

• Health Insurance with no premium for employee coverage.

• Flexible Spending Accounts.

• 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year.

• NC Local Government Retirement Pension (defined-benefit plan).

• 401k with a 5% employer match and immediate vesting.

• Public Service Loan Forgiveness (PSLF) qualifying employer.

• Quarterly stipend for remote work supplies.