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Provider Network Manager Jobs (NOW HIRING)

Novus Group

Provider Network Advocate

Pittsburgh, PA

$48.21/hr

Provider Network Advocate This role serves as the vital bridge between a health insurance company ... Special Project Management: Lead and execute special operational projects as assigned by leadership ...

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 ...

MFS Investment Management

Network Manager

Boston, MA · On-site

$110K - $158K/yr

Additionally, the Network Manager may provide guidance and oversight to a limited number of direct reports including Engineers and Architects, fostering collaboration and development within the team ...

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$106.6K

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How much do provider network manager jobs pay per year?

As of Jul 12, 2026, the average yearly pay for provider network manager in the United States is $106,570.00, according to ZipRecruiter salary data. Most workers in this role earn between $80,500.00 and $128,000.00 per year, depending on experience, location, and employer.

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 highest paying job in healthcare management?

In healthcare management, the highest paying roles are typically executive positions such as Chief Executive Officer (CEO) or Chief Operating Officer (COO) of healthcare organizations, with salaries often exceeding $150,000 annually. These roles require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.

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 jobs in the US pay 300,000 a year?

Provider Network Managers in healthcare organizations can earn $300,000 or more annually, especially with extensive experience, certifications, and leadership responsibilities. High-level executive roles such as Chief Medical Officers or healthcare executives also frequently reach or exceed this salary level. These positions often require strong negotiation skills, industry knowledge, and strategic planning abilities.

What does a provider network manager do?

A provider network manager oversees the relationships between healthcare providers and an organization, ensuring network adequacy, compliance, and quality standards. They coordinate provider contracts, monitor network performance, and work to optimize provider participation, often using data analysis and negotiation skills.

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 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 a network manager's salary?

A Provider Network Manager's salary typically ranges from $70,000 to $120,000 annually, depending on experience, location, and the size of the organization. They often require strong negotiation, healthcare industry knowledge, and certification in network management or related fields.
More about Provider Network Manager jobs
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Provider Network Manager jobs near you
Provider Network Advocate

Provider Network Advocate

Novus Group

Pittsburgh, PA

$48.21/hr

Full-time

Retirement, PTO

Re-posted 9 days ago

Job description

Provider Network Advocate

This role serves as the vital bridge between a health insurance company (payor) and the hospitals, doctors, and clinics (healthcare providers) that deliver care to members.

Role Type: Full-Time, Regular Employee of the Company (Not a temp or contract assignment)

Shift: Day Job (Standard business hours; occasionally requires extended hours beyond a 40-hour workweek based on project demands)

Work Arrangement: Hybrid (Minimum of 3 days per week on-site in Downtown Pittsburgh with occasional local travel for provider site visits)

Location: Pittsburgh, PA 15219

New Hire Starting Salary Range: $27.89 – $32.97 per hour (After hire, pay increases can be earned, see below).

About the Opportunity

This role is a permanent, full-time career opportunity within a premier national health plan network management division. If selected, you will be hired directly as a regular employee of the organization we represent. You will be on their payroll and eligible for their full suite of benefits from your start date. This is not a temporary, contract, or "temp-to-hire" role. This position features a collaborative hybrid layout, blending central corporate headquarters operations with localized community provider engagement.

Purpose

The Provider Network Advocate (PNA) specializes in investigating complex medical claims, supporting network providers, and cultivating strong strategic partnerships. Working in tandem with the Provider Network Liaison (PNL) team, this professional investigates systemic issues across internal departments, performs root-cause analysis, and deploys targeted outreach to resolve complex payment and configuration issues. This role is essential for driving provider operational satisfaction while championing key healthcare quality and compliance initiatives (including HEDIS, HCC, CDPS, and CMS Stars improvements).

Responsibilities

  • Issue Investigation & Resolution: Coordinate multi-departmental problem resolution for provider issues identified through internal data reports or leadership escalations. Conduct deep-dive claims investigations to uncover root causes and ensure a closed feedback loop with the provider.
  • Provider Outreach & Engagement: Conduct strategic outreach via telephone, email, and in-person site visits to educate network providers and their administrative office staff on health plan programs, electronic tools, and dynamic operational initiatives.
  • Quality Initiative Support: Partner with providers on clinical documentation and performance improvement metrics tied directly to HEDIS, HCC, CDPS, Medical Advantage Pay-for-Performance (MA P4P), and CMS Stars ratings.
  • CRM Database Management: Document all provider touchpoints, outreach metrics, and ongoing initiative milestones inside the internal customer relationship management database in a highly detailed, time-sensitive manner.
  • Process Improvement: Collaborate actively with internal Network Leaders and cross-functional teams to identify administrative bottlenecks and enact continuous process improvements across the department.
  • Special Project Management: Lead and execute special operational projects as assigned by leadership, representing the department at internal stakeholder assemblies and external provider meetings.
Minimum Essential Requirements

  • Education Pathways: Bachelor’s Degree in Business, Healthcare Administration, Marketing, or a closely related field OR equivalent professional experience.
  • Core Experience: Minimum of three (3) years of progressive experience in business, sales, or a healthcare-related corporate environment.
  • Direct professional experience within Provider Services, Medical Claims processing, or Member Services—specifically utilizing claims investigation or root-cause problem analysis frameworks
  • Technical Compliance: Exceptional organizational, analytical, and problem-solving skills. Proven ability to document complex workflows and communicate technical information clearly to executive leadership and external clinical partners.
  • Mobility: Ability to travel occasionally throughout the regional area to conduct face-to-face provider site visits and accompany directors to external meetings.
Performance-Based Earning Potential

This role offers a structured path for financial advancement. Through consistent high performance, leadership development, and continuous learning over time, employees have the opportunity to earn up to $48.21 per hour.

Premier Benefits

  • Exceptional Retirement Package: Retirement plans with employer matching. Combined, the organization contributes up to 8% of your eligible pay toward your future.
  • World-Class Healthcare: Access preventive care and specialty services through an exclusive provider network.
  • Generous Paid Time Off: Enjoy up to 5.5 weeks of PTO per year, plus 7 paid holidays, with unique options to buy or sell PTO days to fit your lifestyle.
  • Tuition Assistance: Benefit from up to $6,000 per academic year in tuition reimbursement, plus exclusive tuition discounts at over 30 partner colleges and universities.