Network Specialist

Why consider this job opportunity

• Salary up to $75,000 annually
• Generous paid time off and employer-sponsored health, dental, and vision plans with low or no premiums
• $100 monthly mobile or internet stipend
• Bonus eligibility for all roles excluding Director and above;
  Commission eligibility for Sales roles
• Opportunity for career advancement and growth within the organization
• Commitment to a diverse and vibrant workforce that values collaboration

• Conduct audits of provider setup, demographic information, fee schedules, and claims payments; determine root causes of issues and recommend process improvements
• Analyze network grievances, track trends, and prepare monthly reporting with necessary outreach
• Support network adequacy through contracting processes, including obtaining signatures and preparing provider rosters
• Assist network managers with preparations for monthly meetings, researching financial report outliers, and ensuring audit report accuracy
• Evaluate participation requests against network needs and make recommendations to management

• Minimum of 3 years of direct provider interaction
• Minimum of 3 years of healthcare experience, preferably with Medicare Advantage or other relevant experience
• Proven track record of detail-oriented work
• Proficiency in navigating Google or Microsoft Suite products
• Experience in claims research, provider setup, root cause analysis, and process improvement

• Desire to assist network operations in providing excellent service to providers
• Enthusiasm for a fast-paced organization and openness to change
• Willingness to share experiences to create best practices
• Skills in data evaluation, root cause identification, and synthesis

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.

We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.