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Provider Network Manager Jobs in Crofton, MD (NOW HIRING)

Peraton

Network Services Manager

Washington, DC · Hybrid

$112K - $179K/yr

... our Network Services Manager position. This position leads the Network Services organization ... Provide executive-level briefings and updates to federal leadership on operational status, risks ...

Peraton

Network Services Manager

Washington, DC · On-site

$112K - $179K/yr

... our Network Services Manager position. This position leads the Network Services organization ... Provide executive-level briefings and updates to federal leadership on operational status, risks ...

Peraton

Network Services Manager

Washington, DC · Hybrid

$112K - $179K/yr

... our Network Services Manager position. This position leads the Network Services organization ... Provide executive-level briefings and updates to federal leadership on operational status, risks ...

Waymo

Network Delivery Program Manager

Washington, DC · On-site

$168K - $207K/yr

The Waymo Driver has provided over ten million rider-only trips, enabled by its experience ... Experience managing and collaborating with a network operations center * Experience with Service ...

Waymo

Network Delivery Program Manager

Washington, DC · Hybrid

Provide reliable, resilient, secure digital infrastructure services. Deliver solutions with agility ... Experience managing and collaborating with a network operations center * Experience with Service ...

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All JobsProvider Network JobsProvider Network Manager JobsProvider Network Manager Jobs in Crofton, MD

Provider Network Manager information

See Crofton, MD salary details

$22.2K

$107.8K

$164.3K

How much do provider network manager jobs pay per year?

As of Aug 22, 2026, the average yearly pay for provider network manager in Crofton, MD is $107,775.00, according to ZipRecruiter salary data. Most workers in this role earn between $81,400.00 and $129,400.00 per year, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a provider network manager?

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 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.

Is provider network manager a stressful job?

Provider network managers often face stress due to managing provider relationships, ensuring network compliance, and meeting organizational goals. The role requires strong organizational skills and the ability to handle multiple priorities, which can contribute to a high-pressure environment.

What does a provider network manager do?

A provider network manager oversees the relationships between healthcare providers and an organization, ensuring network adequacy, contract negotiations, and compliance with regulations. They analyze provider data, coordinate with internal teams, and may use network management tools to optimize provider access and quality of care.

What cities near Crofton, MD are hiring for Provider Network Manager jobs?

Cities near Crofton, MD with the most Provider Network Manager job openings:

Provider Network Manager jobs near you
Infographic showing various Provider Network Manager job openings in Crofton, MD as of August 2026, with employment types broken down into 82% Full Time, 17% Part Time, and 1% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $107,775 per year, or $51.8 per hour.

Network Contractor PNM

Amerihealth Caritas

Washington, DC • On-site, Remote

Full-time

Medical, Retirement, PTO

Re-posted 2 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

129th of 311 rated insurance

Job description

Work Arrangement:

This position is a 4 days / week hybrid position in our DC office located at 1201 Maine SW.

As a Provider Network Management Contractor, you will be responsible for the contracting and re-contracting of providers in an established market.
Responsibilities

  • Supports network development strategy.
  • Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication.
  • Responsible for negotiating contracts to execute on network strategy and ensure an adequate, compliant and marketable network.
  • Responsible for negotiating Single Case Agreements (SCA) rates and converting SCA providers to contracted.
  • Responsible for recruiting and contracting providers based on identified network adequacy gaps (high complexity).
  • Ensures all contracts are negotiated to be compliant with Federal and State rules, regulations, policies and procedures and follow all departmental policies.
  • Ensures contracts are supportive of Plan quality initiatives such as HEDIS, CAHPS and NCQA/URAC.
  • Negotiates contracts to support management of provider satisfaction.
  • Contractors will work with Corporate Provider Network Management to manage the annual contracting schedule as well as supplement the network as new providers are available or needed.
  • Payment/fee schedule SME's to develop resources in complex specialties i.e. FQHCs, BH, anesthesia etc. These SMEs will be available to AEs when needed for support of claims resolution.
  • General Operational Knowledge related to provider satisfaction, education and communication with a fundamental understanding of operational items such as claims, payment integrity, provider data, credentialing, appeals disputes etc.
  • Negotiates provider contracts consistent with claim payment methodologies.
  • Augments and modifies the existing provider network to accommodate new products or clients as necessary.
  • Reviews contract language and collaborates with legal to ensure best contract terms.
  • Support contracting for multiple product lines, including Exchange, DSNP.
  • Lead negotiator of Value Based Contracting in conjunction with AE.

Education and Experience

  • Associates Degree required.
  • Bachelor's Degree preferred.
  • Master's Degree highly preferred.
  • Minimum of three (3) years of Account Executive experience.
  • Minimum of one (1) year of contract negotiation experience.

Skills

  • Understanding of reimbursement methodologies to include Risk or Value Based contracting.
  • Ability to have difficult conversations.
  • Financial acumen.
  • Proficiency using MS Office Suite.

The targeted hiring range for this role is expected to be between 92,800 and 126,400. The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the Washington D.C. area. Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Employment Type: FULL_TIME

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