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Provider Network Manager Jobs in Virginia (NOW HIRING)

Veracity

Network Manager V

Newport News, VA · On-site

The candidate will manage network configurations, ensure system security, and provide support across multiple technologies (Cisco, Juniper, Aruba). The role will require expertise in maintaining ...

RecruitTalent LLC.

Network Manager

Suffolk, VA · On-site

Network Manager Location : Onsite-Suffolk, VA Job Summary: We are seeking a highly skilled and ... Lead a team of network professionals, providing guidance and training as needed. * Collaborate with ...

Streamed Hire, LLC

Be Seen First

Network Manager

Sterling, VA · On-site

$100K - $130K/yr

Participate in project meetings and provide status updates to stakeholders Required Qualifications: * 5+ years of experience in network engineering or network management * Active Cisco certification ...

InterSources

Network Manager

Stafford, VA · On-site

... build a cohesive network team; • Ability to manage staff in a collaborative environment ... We provide strategic and technical advice, and we have expertise in areas covering Artificial ...

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Provider Network Manager information

See Virginia salary details

$21.8K

$105.7K

$161.1K

How much do provider network manager jobs pay per year?

As of May 28, 2026, the average yearly pay for provider network manager in Virginia is $105,656.00, according to ZipRecruiter salary data. Most workers in this role earn between $79,800.00 and $126,900.00 per year, depending on experience, location, and employer.

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

To thrive as a Provider Network Manager, you need expertise in healthcare network development, contract negotiation, and knowledge of insurance regulations, often supported by a bachelor's degree in business, healthcare administration, or a related field. Familiarity with network management software, claims processing systems, and regulatory compliance platforms is typically required. Strong interpersonal skills, analytical thinking, and effective communication are crucial for building relationships and resolving issues with providers. These skills ensure efficient network operations, regulatory adherence, and the delivery of high-quality, cost-effective healthcare services.

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

Provider Network Managers often encounter challenges such as balancing competitive reimbursement rates with cost containment goals, navigating complex regulatory requirements, and addressing provider concerns regarding network participation. They must also ensure that contracts align with organizational standards while maintaining positive relationships with providers. Effective communication, negotiation skills, and a solid understanding of both payer and provider perspectives are crucial for overcoming these obstacles and building a robust network.

What is a Provider Network Manager?

A Provider Network Manager is a professional responsible for developing, maintaining, and optimizing relationships with healthcare providers within a health insurance organization's network. They negotiate contracts, ensure provider compliance with policies, and work to expand or improve the network to meet the needs of members. Their role often involves analyzing network performance, resolving issues between providers and the insurer, and ensuring the network meets regulatory requirements. Provider Network Managers play a crucial part in ensuring quality, accessible, and cost-effective care for insured individuals.

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

AspectProvider Network ManagerProvider Relations Specialist
CredentialsTypically requires a bachelor's degree in healthcare administration, business, or related field; certifications like CPC or CHC are commonOften requires similar credentials, with a focus on communication or healthcare certifications
Work EnvironmentWorks in healthcare organizations, insurance companies, or managed care settings, managing networks and contractsWorks in provider offices or insurance companies, focusing on building and maintaining provider relationships
Employer & Industry UsageCommonly employed by health plans, insurance companies, and healthcare networksEmployed by insurance companies, healthcare providers, and managed care organizations

The Provider Network Manager and Provider Relations Specialist roles share overlapping credentials and work environments within healthcare and insurance industries. While the Provider Network Manager focuses on managing provider networks and contracts, the Provider Relations Specialist emphasizes building provider relationships and communication. Both roles are essential for effective healthcare delivery and insurance operations, often working closely together to ensure provider satisfaction and network efficiency.

What are the most commonly searched types of Provider Network jobs in Virginia? The most popular types of Provider Network jobs in Virginia are:
What are popular job titles related to Provider Network Manager jobs in Virginia? For Provider Network Manager jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Provider Network Manager jobs in Virginia look for? The top searched job categories for Provider Network Manager jobs in Virginia are:
What cities in Virginia are hiring for Provider Network Manager jobs? Cities in Virginia with the most Provider Network Manager job openings:
Provider Network Manager jobs near you
Infographic showing various Provider Network Manager job openings in Virginia as of May 2026, with employment types broken down into 1% As Needed, 63% Full Time, 33% Part Time, and 3% Contract. Highlights an 78% Physical, 2% Hybrid, and 20% Remote job distribution, with an average salary of $105,656 per year, or $50.8 per hour.
Provider Network Operations Advisor - Cigna Healthcare - Hybrid

Provider Network Operations Advisor - Cigna Healthcare - Hybrid

Cigna

Mclean, VA • Hybrid

Full-time

Posted 12 days ago

Cigna Healthcare rating

8.3

Company rating: 8.3 out of 10

Based on 215 frontline employees who took The Breakroom Quiz

33rd of 864 rated healthcare providers

Job description

Join our team as a Provider Network Operations Advisor, playing a key role in creating and maintaining provider networks that deliver quality, affordability, and access to care. This role shapes provider network strategy across a matrixed group of partners, using data to driveinitiatives that support Cigna Enterprise goals and directly impact our clients and customers.

Key Responsibilities

Provider Data Resolution

  • Support the management and implementation of provider, hospital, and ancillary networks by researching and resolving provider data issues, including demographic, claims, and system loading errors.
  • Troubleshoot issues escalated by Market Network Advisors using Cigna systems such as HCPM, Cognos, and the Developer Database.
  • Respond to questions from the Contracting team and matrix partners related to provider locations, policies, and data accuracy.
  • Perform rate and fee schedule audits upon request.
  • Support accurate loading of provider contracts and reimbursement methodologies.

Market Guidebooks

  • Create, manage, and maintain Market Guidebooks, including rate updates, provider inclusion/exclusion, and audit documentation.
  • Advise Market leadership and the National Alternative Access Network Manager on market-specific network dynamics.
  • Participate in quarterly reviews, identify corrections, and assist with provider terminations, additions, and updates.

Alternative Access Network (AAN)

  • Serve as the market subject matter expert for Alternative Access Networks, including inclusion/exclusion criteria and anchor providers.
  • Develop and maintain the AAN field guide for Contracting teams.
  • Coordinate, edit, and approve AAN communications, such as provider notices and Sales materials.
  • Conduct provider research and approve mailing lists for new or expanded product offerings.
  • Perform ongoing network maintenance, answer questions, and resolve issues.
  • Partner with the Network Manager on Split TIN handling and loading for IFP.

Affordability

  • Facilitate monthly affordability calls and agendas.
  • Monitor opportunity detection tools and support total medical cost savings through provider research, claims analysis, action planning, and outcome monitoring.
  • Partner with Market Medical Directors and Data Analytics on savings opportunities.
  • Perform medical benchmarking and network modeling using HPN tools.

Compliance - Network Adequacy & State Filings

  • Partner with matrix teams to ensure accurate provider data for filings, including hospital listings and state-specific requirements for the Mid-Atlantic market.
  • Support recruitment efforts to address network adequacy gaps by validating provider locations, specialties, and viability.

HSCRC - State of Maryland

  • Represent the market on monthly state-facilitated calls.
  • Provide regulatory updates to Contracting leadership and the Market Medical Director.
  • Participate in AHEAD learning activities and support related initiatives.

Regulatory Compliance - Mid-Atlantic

  • Support subject matter expertise related to the No Surprises Act, CMS guidance, and federal and state regulations.
  • Partner with business owners to ensure workflows and policies are implemented in a timely manner.
  • Identify operational gaps and recommend process improvements.

Qualifications

  • Bachelor's degree or equivalent experience required.
  • 5+ years of experience in provider network management or healthcare insurance.
  • Project management experience preferred.
  • Strong analytical, problem-solving, and critical-thinking skills.
  • Excellent communication, stakeholder management, and organizational skills.
  • Healthcare compliance and regulatory experience preferred.
  • Knowledge of CMS regulations, NSA, and reimbursement structures preferred.
  • Ability to work independently and manage multiple priorities.
  • Proficiency in Microsoft Office; Cigna systems experience preferred.
  • Local market knowledge preferred.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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