SUMMARY The Provider Network Specialist provides operational support for provider network management and credentialing functions. This position serves as a resource for provider onboarding ...
Quick apply
SUMMARY The Provider Network Specialist provides operational support for provider network management and credentialing functions. This position serves as a resource for provider onboarding ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
Participate in Network Management projects and initiatives to support departmental goals. Support cross-functional collaboration to resolve routine provider operational concerns. DEPARTMENT ...
Participate in Network Management projects and initiatives to support departmental goals. Support cross-functional collaboration to resolve routine provider operational concerns. DEPARTMENT ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department ...
Ensure network practitioners are credentialed per plan policies. * Ensure provider data systems are optimized to enable strategic network management, including accurate and timely claims processing ...
Ensure network practitioners are credentialed per plan policies. * Ensure provider data systems are optimized to enable strategic network management, including accurate and timely claims processing ...
Ensure network practitioners are credentialed per plan policies. * Ensure provider data systems are optimized to enable strategic network management, including accurate and timely claims processing ...
Ensure network practitioners are credentialed per plan policies. * Ensure provider data systems are optimized to enable strategic network management, including accurate and timely claims processing ...
OR · On-site
As the Manager, Lifecycle Marketing for the Provider Network at BetterHelp, you'll join a diverse ... The ideal candidate has deep CRM and lifecycle expertise, strong analytical skills, and experience ...
OR · On-site
As the Manager, Lifecycle Marketing for the Provider Network at BetterHelp, you'll join a diverse ... The ideal candidate has deep CRM and lifecycle expertise, strong analytical skills, and experience ...
Manages territory of assigned network partnerships, that may include Special Kids Special Care (SKSC) providers, HRSN (Health Related Social Needs) providers, primary care providers, specialists ...
Manages territory of assigned network partnerships, that may include Special Kids Special Care (SKSC) providers, HRSN (Health Related Social Needs) providers, primary care providers, specialists ...
Knowledge of healthcare regulations and provider network requirements. * Previous full cycle recruiting experience. * Proficiency in contract negotiation and compliance. * Ability to manage multiple ...
Knowledge of healthcare regulations and provider network requirements. * Previous full cycle recruiting experience. * Proficiency in contract negotiation and compliance. * Ability to manage multiple ...
Provider Relations Representative
Roseburg, OR · On-site
$59K - $68K/yr
Representatives work under the direction of the Provider Relations Manager and collaborate with Network Contracting, Customer Care, and other departments. Representatives may serve as a generalist ...
Provider Relations Representative
Roseburg, OR · On-site
$59K - $68K/yr
Representatives work under the direction of the Provider Relations Manager and collaborate with Network Contracting, Customer Care, and other departments. Representatives may serve as a generalist ...
... Vendor Management Programs. Collabera recognizes true potential of human capital and provides ... Troubleshoot network hardware and software, working with 3rd party hardware vendors and suppliers ...
... Vendor Management Programs. Collabera recognizes true potential of human capital and provides ... Troubleshoot network hardware and software, working with 3rd party hardware vendors and suppliers ...
Provider Relations Representative
Roseburg, OR · On-site
$59K - $68K/yr
Representatives work under the direction of the Provider Relations Manager and collaborate with Network Contracting, Customer Care, and other departments. Representatives may serve as a generalist ...
Quick apply
Provider Relations Representative
Roseburg, OR · On-site
$59K - $68K/yr
Representatives work under the direction of the Provider Relations Manager and collaborate with Network Contracting, Customer Care, and other departments. Representatives may serve as a generalist ...
Network Enterprise Management Design Engineer Senior with Security Clearance
Pendleton, OR · On-site
$105K - $144K/yr
We re seeking an experienced Network Enterprise Management Design Engineer Senior to support daily ... Provide technical leadership on large-scale system integration and testing. * Design solutions for ...
Network Enterprise Management Design Engineer Senior with Security Clearance
Pendleton, OR · On-site
$105K - $144K/yr
We re seeking an experienced Network Enterprise Management Design Engineer Senior to support daily ... Provide technical leadership on large-scale system integration and testing. * Design solutions for ...
Ability to organize and prioritize work and manage multiple priorities. * EDUCATION and/or ... provide basic direction. X Ability to transcribe dictation; make appointments and process mail ...
Ability to organize and prioritize work and manage multiple priorities. * EDUCATION and/or ... provide basic direction. X Ability to transcribe dictation; make appointments and process mail ...
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
SHP Provider Contract Consultant
Corvallis, OR · On-site
$35.26 - $52.90/hr
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
SHP Provider Contract Consultant
Corvallis, OR · On-site
$35.26 - $52.90/hr
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
Three (3) years of progressive experience in provider contracting, network management, or managed care operations required. * Experience negotiating hospital and/or professional agreements required.
Provider Network Management information
What is a Provider Network Management job?
A Provider Network Management job involves building, maintaining, and optimizing a healthcare provider network. Professionals in this role negotiate contracts, ensure provider compliance with regulations, and manage relationships with healthcare providers to maintain quality care and cost efficiency. They also analyze network performance, address gaps in coverage, and facilitate collaboration between insurers and providers. The goal is to ensure patients have access to high-quality care while keeping costs sustainable for healthcare organizations.
What are the key skills and qualifications needed to thrive in the Provider Network Management position, and why are they important?
To excel in Provider Network Management, candidates typically need expertise in healthcare administration, contract negotiation, analytics, and a degree in a related field such as health services administration or business. Familiarity with network management platforms, claims processing systems, provider directories, and knowledge of regulations like HIPAA are highly valuable, as are certifications such as CPC or CPHQ. Strong relationship-building, problem-solving, and communication skills set top performers apart in facilitating partnerships between providers and healthcare payers. These abilities are essential to maintain robust provider networks, ensure compliance, and deliver quality healthcare services efficiently.
What are the typical daily responsibilities in a Provider Network Management role?
In a Provider Network Management role, your day might include negotiating and administering contracts with healthcare providers, analyzing network performance metrics, and resolving provider issues or escalations. You’ll often collaborate with cross-functional teams such as claims, credentialing, and member services to ensure seamless network operations. Building and maintaining strong relationships with providers to address their needs, review compliance, and monitor service quality is a core part of the job. This position typically involves a mix of desk work, meetings, and occasional travel to visit provider offices or attend industry events.
What are popular job titles related to Provider Network Management jobs in Oregon? For Provider Network Management jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Provider Network Management jobs in Oregon look for? The top searched job categories for Provider Network Management jobs in Oregon are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 8 days ago
Job description
SUMMARY
The Provider Network Specialist provides operational support for provider network management and credentialing functions. This position serves as a resource for provider onboarding, credentialing coordination, provider data maintenance, provider communications, reporting support, and provider network administration activities. The Provider Network Specialist works collaboratively with internal departments, providers, medical groups and administrative staff to ensure accurate provider information, timely credentialing and recredentialing activities, compliance with organizational requirements, and a positive provider experience by performing the following duties.
- Supports provider onboarding, credentialing, and recredentialing activities to ensure providers meet participation requirements and maintain compliance.
- Maintains accurate provider demographic and directory information to support regulatory compliance and member access to care.
- Assists with provider relations activities, including provider outreach, education, communications, issue resolution, and onboarding support.
- Supports provider network monitoring activities, including access and availability reviews, ADA accommodation tracking, secret shopper reviews, and provider data validation.
- Coordinates administrative activities for provider network management and credentialing, including report preparation, Provider Network Management Committee support, document management, and project tracking.
- Serves as administrative support contact for provider and clinic inquiries related to network participation, directory information and provider relations.
- Assists with provider onboarding activities, including collection and tracking of required documentation.
- Conducts routine provider outreach to verify provider information, office hours, capacity, ADA accommodations, and other network data.
- Assists with provider recruitment activities by coordinating outreach efforts, tracking opportunities, and maintaining recruitment records.
- Supports provider education initiatives through preparation and distribution of provider communications, training materials and updates.
- Maintains provider contract warehouse and other related documentation.
- Assists with preparation of provider network adequacy, access, and availability metrics to assist with monitoring procedures.
- Provides administrative support for the credentialing and recredentialing process.
- Conducts outreach to providers, clinics, and office staff regarding missing or incomplete credentialing documentation when necessary.
- Performs data entry and updates provider information within credentialing and provider management systems.
- Responds to routine credentialing inquiries.
- Maintains confidentiality and complies with HIPAA rules and regulations.
- Maintains punctual, regular, and predictable attendance.
- Works collaboratively in a team environment with a spirit of cooperation.
- Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members and coworkers, including the ability to communicate effectively and remain calm and courteous under pressure.
- Respectfully takes direction from manager.
EDUCATION and/or EXPERIENCE
Associate's degree or equivalent from two-year college or university; and two to three years related experience and/or training; or equivalent combination of education and experience.
COMPUTER SKILLS
Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, report writing, project management, graphics, word processing, presentation creation/editing, communicate by e-mail and use scheduling software.
We provide a competitive salary and excellent benefits, including vacation, medical, dental and vision insurance, and 401(k) pension plan. To apply for this position, please submit a cover letter and resume. We are an Equal Opportunity Employer.
Background Check & Drug Screen Required