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Provider Network Consultant Jobs (NOW HIRING)

Senior Network Consultant

Waltham, MA · On-site

$112K - $153K/yr

Provide seniorlevel technical escalation for complex network or security incidents. * SupportBulletproof'sNOC environment and systems and provide best practice procedures formonitoringour clients

... consultation, market and provider performance improvement plans, and Client Services business ... This includes oversight of Provider Network planning to ensure the Network has enough viable ...

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Provider Network Consultant information

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$12

$44

$62

How much do provider network consultant jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for provider network consultant in the United States is $44.45, according to ZipRecruiter salary data. Most workers in this role earn between $38.46 and $49.76 per hour, depending on experience, location, and employer.

What are high paying consultant jobs?

High-paying consultant jobs often include management consultants, IT consultants, and financial advisors, with salaries exceeding $100,000 annually. These roles typically require specialized skills, certifications, and experience, and may involve working with large organizations or on complex projects.

What does a network consultant do?

A provider network consultant analyzes and manages healthcare provider networks to ensure efficient service delivery and cost management. They review provider contracts, optimize network configurations, and collaborate with healthcare organizations to improve network performance, often using data analysis tools and industry regulations.

What is the difference between Provider Network Consultant vs Provider Relations Specialist?

AspectProvider Network ConsultantProvider Relations Specialist
CredentialsTypically requires healthcare or insurance-related certifications, bachelor’s degreeOften requires similar healthcare or insurance background, certifications vary
Work EnvironmentWorks with healthcare providers, insurance companies, and internal teams to develop and manage provider networksFocuses on building and maintaining relationships with healthcare providers, handling provider inquiries
Employer & Industry UsageCommon in health insurance companies, managed care organizationsFound in insurance companies, healthcare organizations, and provider networks

Both roles involve working with healthcare providers and require similar certifications. The Provider Network Consultant typically focuses on designing and optimizing provider networks, while the Provider Relations Specialist emphasizes maintaining provider relationships and communication. The roles often overlap but differ mainly in scope and focus within the healthcare industry.

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

To thrive as a Provider Network Consultant, you need expertise in healthcare network management, contract negotiation, and a bachelor’s degree in healthcare administration or a related field. Familiarity with claims management software, provider databases, and knowledge of regulatory compliance are typically required, along with certifications such as CPC (Certified Provider Credentialing Specialist) being advantageous. Strong communication, relationship-building, and analytical skills set top performers apart in this role. These abilities are crucial for optimizing provider networks, ensuring regulatory compliance, and building effective partnerships that enhance healthcare delivery.

What does a provider consultant do?

A provider network consultant evaluates and manages relationships with healthcare providers to ensure network adequacy and compliance. They analyze provider data, negotiate contracts, and support the integration of providers into health plans or networks, often using industry tools and data analysis skills.

What job makes $10,000 a month without a degree?

A Provider Network Consultant can potentially earn $10,000 or more per month through experience, specialized knowledge, and strong negotiation skills in healthcare network management. High earnings are often associated with senior roles, certifications, and a deep understanding of insurance and provider contracts. Such roles typically require industry experience rather than formal degrees.

What are Provider Network Consultants?

Provider Network Consultants are professionals who work primarily within the healthcare industry to build, maintain, and optimize the network of healthcare providers for insurers or managed care organizations. They are responsible for recruiting new providers, negotiating contracts, ensuring compliance with regulations, and addressing network adequacy and performance issues. Their work helps ensure that members have access to a robust network of doctors, hospitals, and other healthcare professionals while balancing quality, cost, and coverage requirements.

What are some common challenges faced by Provider Network Consultants when negotiating contracts with healthcare providers?

Provider Network Consultants often encounter challenges such as balancing cost containment for the insurance company with competitive reimbursement rates for providers, navigating complex regulatory requirements, and addressing provider concerns about contract terms. Effective negotiation requires strong communication skills and a thorough understanding of both payer priorities and provider needs. Additionally, consultants must stay up-to-date on market trends and ensure network adequacy to meet member access standards.
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What states have the most Provider Network Consultant jobs? States with the most job openings for Provider Network Consultant jobs include:
What job categories do people searching Provider Network Consultant jobs look for? The top searched job categories for Provider Network Consultant jobs are:
Provider Network Manager - Tampa

Provider Network Manager - Tampa

Solis Health Plans

Miami, FL • On-site

$80K - $85K/yr

Full-time

Medical, Dental, Vision, Retirement

This job post has expired 1 day ago. Applications are no longer accepted.


Job description

About us:

Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!

*Candidates must be local to Tampa*

**BILINGUAL - ENGLISH & SPANISH IS REQUIRED**


POSITION SUMMARY:

The Provider Network Manager is responsible for developing and retaining business and providing excellent service to clients in the specified geographic region. The ideal person will have proven experience building on existing relationships, eliminating competitive threats within our network base, and ensuring satisfaction within our accounts.

ESSENTIAL DUTIES AND RESPONSIBILTIES:

• Generates and develops new business to meet specified production goals.

• Maintains and nurtures existing client relationships.

• Responds to all inquiries and requests in a timely and professional manner.

• Functions as liaison between client companies and operations staff.

• Understands and communicates information regarding company products, services, and policies and procedures to new and existing clients.

• Possesses and maintains thorough knowledge of Medicare Advantage Plan product information.

• Continually gathers information on local competition and prevalent industry and business climate within the region; communicates information to management and others as needed.

• Works with more complex providers. Complex providers may include, but are not limited to large institutional providers, and large medical groups, value-based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required.

• Conducts more complex negotiations and drafts documents.

• Ensures that all required client paperwork is complete, accurate, and submitted on time.

• Provides timely and accurate reports as required.

• Strong background in value based/full risk PCP MSO/IPA arrangements related to Medicare Advantage and other governmental programs.

• Attends and participates in business/trade events that impact business unit.

• Attends and participates in team strategic sales meetings.

• Performs other related duties as assigned by management.


QUALIFICATIONS & EDUCATION:

• Bachelor's degree (B. A.) or equivalent, 6 years of experience, or equivalent combination of education and experience.

5 years of experience in value based contract agreement (care).

Bilingual in Spanish preferred

• 5 years Medicare Advantage Plan.

• Provider Network experience.

• Must be a self-starter and proactive.

• Commitment to excellence and high standards.

• Excellent written and verbal communication skills.

• Good judgement with the ability to make timely and sound decisions.

• Creative, flexible, and innovative team player.

• Demonstrated ability to make successful presentations to individuals and/or groups at all levels of an organization.

• Strong organizational skills; able to manage priorities and workflow.

• Ability to work independently and as a member of various teams and committees.

• Ability to calculate figures and amounts such as discounts, interest, commissions, and percentages.

• Excellent problem resolution and consultative sales skills.

• Proven ability to handle multiple projects and meet deadlines

• Strong interpersonal skills.

• Ability to prepare reports and business correspondence.

• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.

What set us apart:

Join Solis Health Plans as a Provider Network Manager and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!

JOIN OUR RAPIDLY GROWING TEAM! Our company has doubled in size, and we've grown our membership from 2,000 to over 10,000 members—and we're just getting started!

Benefits include (starting the first of the month following your hire date):

  • Medical, Dental, and Vision Insurance

  • 401(k) plan with 100% company match

Be part of something big. Join our winning Solis Team today!