Provider Network Support

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate provider rosters and network information to pinpoint deficiencies in specialty coverage, geographic accessibility, appointment availability, and credentialing status.

• Collaborate with network and clinical stakeholders to verify data and monitor remediation efforts.

• Create and sustain provider capacity analyses, enrollment dashboards, status reports, and materials for leadership briefings.

• Assess provider enrollment and credentialing processes, metrics, delays, and compliance issues, and suggest practical enhancements.

• Assist in provider recruitment, communication, training, and the prioritization of credentialing activities.

• Offer consultative assistance for network-related escalations and aid in identifying qualified providers for member care requirements.

• Facilitate single case agreements and letters of agreement via established review and approval protocols.

• Perform quality evaluations and audits of provider files and network processes, document findings, and monitor corrective measures.

• Create or revise SOPs, process maps, training materials, templates, and other resources for knowledge management.

• Engage in program meetings, document resolutions and action items, and coordinate follow-up with relevant stakeholders.

• Protect member, provider, and program information in compliance with applicable privacy, security, and records management regulations.

⛳️ Requirements

• Experience in supporting provider network operations, provider enrollment, credentialing, healthcare operations, managed care, or a similar function.

• Proven ability to analyze operational data, detect gaps or trends, and convert findings into actionable recommendations.

• Experience in developing dashboards, reports, process documentation, or briefing materials.

• Strong organizational, analytical, problem-solving, written communication, and stakeholder coordination skills.

• Capability to manage recurring deliverables, maintain accurate documentation, and track issues until resolution.

• Ability to appropriately handle sensitive healthcare and provider information.

• Proficiency in MS Office, including Word, Excel, PowerPoint, and Outlook.

• Familiarity with communication tools such as Teams and SharePoint.

🏝️ Benefits

• Paid leave

• Employer-sponsored group medical insurance options

• Dental insurance options

• Vision insurance options

• Short-term disability insurance

• Long-term disability insurance

• Life insurance

• AD&D coverage

• Legal services

• Identity theft insurance

• Accident insurance

• Flexible spending account options

• Health savings account options

• Employer contribution match through the company-sponsored 401(k) retirement plan, immediately vested

• Professional courses

• Certifications

• Tuition reimbursement programs