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Healthcare Provider Network Jobs (NOW HIRING)

Oakmont Senior Living

Care Provider

Las Vegas, NV · On-site

$15/hr

Position: Care Provider Shifts, Time, and Days: Friday through Monday from 6:30am to 2:45pm Pay ... For the health and safety of our team members and residents, Oakmont Management Group may require ...

Oakmont Senior Living

Care Provider

Honolulu, HI

$19 - $20/hr

Care Provider Shifts, Time, and Days: FULL TIME Pay Range:$19.00-$20.00 per hour IVY AT HAWAII KAI ... For the health and safety of our team members and residents, Oakmont Management Group may require ...

Oakmont Senior Living

Care Provider

La Palma, CA

$17 - $18/hr

Care Provider Part time: Assisted Living or Memory Care Pay Range: $17.00 to $18.00 per hour Ivy ... For the health and safety of our team members and residents, Oakmont Management Group may require ...

Oscar Health

SVP, Network & Provider Management

New York, NY · On-site

$319K - $419K/yr

... changing healthcare trends and member needs. * Utilize market trends and data to inform network ... Provide central management of contract inventory, renewals and amendments, ensuring all agreements ...

Oscar Health

SVP, Network & Provider Management

New York, NY · Hybrid

$319K - $419K/yr

... changing healthcare trends and member needs. * Utilize market trends and data to inform network ... Provide central management of contract inventory, renewals and amendments, ensuring all agreements ...

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How much do healthcare provider network jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for healthcare provider network in the United States is $31.82, according to ZipRecruiter salary data. Most workers in this role earn between $14.90 and $28.37 per hour, depending on experience, location, and employer.

What is a healthcare provider network?

A healthcare provider network is a group of doctors, hospitals, and other healthcare professionals that have agreed to provide medical services to members of a specific health insurance plan at negotiated rates. These networks help insurance companies manage costs and ensure that patients have access to a range of healthcare services. Patients typically pay less when receiving care from providers within the network, while going outside the network may result in higher costs or limited coverage.

What are the key skills and qualifications needed to thrive as a Healthcare Provider Network Manager, and why are they important?

To thrive as a Healthcare Provider Network Manager, you need expertise in healthcare administration, contract negotiation, and provider relations, typically backed by a degree in healthcare management or a related field. Familiarity with network management software, claims processing systems, and knowledge of regulatory requirements such as HIPAA are essential. Strong interpersonal, organizational, and problem-solving skills help you build relationships and navigate complex negotiations. These capabilities ensure effective network growth, cost control, and high-quality care delivery within the healthcare system.

What are some common challenges faced by professionals working in healthcare provider network management?

Professionals in healthcare provider network management often face challenges such as maintaining up-to-date provider directories, ensuring compliance with complex regulatory requirements, and negotiating contracts that balance quality care with cost efficiency. Additionally, collaborating with both internal teams and external providers can require strong communication and relationship-building skills. Staying informed about evolving healthcare regulations and payer policies is also essential to effectively manage network adequacy and performance.
What states have the most Healthcare Provider Network jobs? States with the most job openings for Healthcare Provider Network jobs include:
Healthcare Provider Network jobs near you
Provider Network Operations Analyst Sr

Provider Network Operations Analyst Sr

AmeriHealth Caritas Health Plan

Manchester, NH • On-site

Full-time

Posted 6 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

87th of 260 rated insurance

Job description

Role Overview: The Senior Provider Network Operations Analyst responsible for maintaining current provider data and provider reimbursement setup, and to address provider and state inquiries as they relate to claim payment issues.
Work Arrangement:
  • Hybrid - The associate must be in the office at least three (3) days per week at our Manchester, New Hampshire (NH) location.

Responsibilities:
  • Review/approves and audits Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries
  • User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production
  • Facets claims edit configuration concentration (Appian) - intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and claims post-production
  • Encounter error reconciliation representation, oversight and management - including identification and initiation of claim or provider changes necessary to mitigate/prevent future errors
  • Management and resolution of state complaints
  • State policy and contract amendment changes analysis and management
  • Internal or vendor medical policy or Health Value Optimization (HVO) edit changes and initiatives
  • Monitor and review state communications and changes, lead initial analysis/determination of action, provide direction on work request submissions to level I analysts, and test/audit subsequent changes
  • Business Process Outsourcing (BPO) and/or other intake/workflow tool management
  • Single-case agreement management/ownership, including letter development and coordination with Provider Network Management (PNM)
  • Serves as the subject matter expert in State specific health reimbursement rules and provider billing requirements and as liaison to the Enterprise Operations Configuration Department
  • Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy and operational procedures to effectively provide technical expertise and business rules
  • Acts as the resource to other departments by developing and managing work plans which document the status of key relationship issues and action items for high profile providers
  • Performs other related duties and projects as assigned

Education & Experience:
  • Associate's degree preferred, or equivalent combination of education and experience in a healthcare field.
  • American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
  • 3 to 5 years of claims analysis experience in healthcare, managed care, or Medicaid environment preferred.
  • Strong working knowledge of Microsoft Excel, Access, Word, and other MS Office tools; ability to work with pivot charts, Access databases, and data analytics.
  • Claims processing and provider data maintenance knowledge required
  • Understanding of and experience related to healthcare claims payment configuration process/systems and its relevance/impact on network operations required

Skills & Abilities:
  • Ability to focus on technology and business issues, as well as communicate appropriately with both technology and business experts
  • Superior organizational skills required
  • Critical thinking skills
  • Strong customer service skills
  • Data and reporting analysis

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