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Provider Network Operation Management Consultant Jobs

Abilis Health Plan

Provider Network Manager

Louisville, KY · On-site +1

$70K - $80K/yr

Familiarity with health plan operations, including benefits, claims review and resolution, eligibility, provider data management, and network operations. * Knowledge of CMS network adequacy standards ...

Sonrava Health

Provider Network Manager

Sacramento, CA · Remote

$80K - $85K/yr

... management throughout Northern California. This full-time, remote position is an excellent ... Serve as the primary point of contact for provider operational and network-related questions.

Oscar Health

Provider Network Coordinator

Tempe, AZ · On-site

$25.44 - $33.39/hr

We're hiring a Provider Network Coordinator to join our Network Contracting team. Oscar is the ... in project management, operations or related * 1+ years of experience with Word, Excel, and ...

Oscar Health

Provider Network Coordinator

Saint Louis, MO · Remote

$25.44 - $33.39/hr

We're hiring a Provider Network Coordinator to join our Network Contracting team. Oscar is the ... in project management, operations or related * 1+ years of experience with Word, Excel, and ...

Elevance Health

Provider Network Manager Sr

Las Vegas, NV · On-site

$91K - $144K/yr

Provider Network Manager Sr Provider Network Manager Sr - Colorado Anticipated Job Posting End Date ... Strong project management skills * Comprehensive negotiation skills supporting multi-service lines ...

Lowe's

PROvider Network Specialist

Mooresville, NC · On-site

$20.67 - $34.52/hr

Your Impact The PROvider Network Specialist is primarily responsible for completing specific ... Management & Service Support guidelines Manages the set-up process for all PROviders through ...

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How much do provider network operation management consultant jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for provider network operation management 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.

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Infographic showing various Provider Network Operation Management Consultant job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 88% Full Time, 7% Part Time, and 4% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $92,465 per year, or $44.5 per hour.

Provider Network Manager

Louisville, KY • On-site, Remote

Abilis Health Plan
See more jobs at Abilis Health Planexternal

$70K - $80K/yr

Full-time

Medical

Posted 25 days ago

Job description

Our Company

Abilis Health Plan

Overview

The Provider Network Manager is responsible for maintaining and enhancing provider networks within an assigned territory through provider relations, network development, and routine contracting activities. The Provider Network Manager serves as a primary contact for contracted providers, conducts provider education and outreach, identifies and addresses network opportunities, and supports provider recruitment efforts. The position also monitors market changes and network performance to ensure adequate provider coverage and compliance with CMS network adequacy standards and all applicable regulatory requirements.

Responsibilities
  • Manage provider relationships within assigned markets, serving as a primary point of contact for contracted providers and addressing network-related issues and inquiries.
  • Perform routine provider contracting and recruitment activities to support network growth, address coverage gaps, and maintain adequate provider access.
  • Conduct provider education and outreach activities to promote provider engagement, communication, and understanding of health plan requirements and initiatives.
  • Monitor and report market and provider changes that may impact network performance, access, or compliance within assigned territories.
  • Collaborate with internal departments to resolve provider issues, support operational initiatives, and improve network effectiveness.
  • Promote a positive and collaborative work environment that supports continuous improvement and organizational success.
  • Complete all assigned corporate responsibilities, including compliance training and other organizational requirements.
Qualifications
  • Associate's Degree or equivalent work experience.
  • Five (5)+ years of experience in managed care, provider network development, provider relations, contracting, or a related healthcare field.
  • Prior experience with Medicare Advantage plans required; Institutional Special Needs Plan (I-SNP) experience preferred.
  • Experience building and maintaining provider relationships, conducting provider education, and supporting provider engagement initiatives.
  • Reliable transportation.
  • Current automobile insurance which meets company policy requirements.
  • Familiarity with health plan operations, including benefits, claims review and resolution, eligibility, provider data management, and network operations.
  • Knowledge of CMS network adequacy standards, provider recruitment, and regulatory compliance requirements preferred.
  • Strong organizational, presentation, and time management abilities.
  • Effective communication skills.
  • Working knowledge of Medicare payment methodologies.
  • Ability to follow instructions and work independently to achieve goals and complete assignments.
  • Proven success working collaboratively in a team environment.
  • Proficient in Microsoft Office Suite and other relevant computer applications.
  • Self-motivated, dependable, team-oriented, and goal-oriented.
  • Skilled at managing multiple priorities effectively.
  • Travel up to 25%
About our Line of BusinessAbilis Health Plan, an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare (Parts A and B) with prescription drug coverage (Part D). The Abilis Health Plan is a unique plan allowing members to enroll year-round. The plan focuses on members who meet residential requirements in participating nursing facilities. An interdisciplinary team of clinicians and innovative services allow us to meet each member's clinical needs and provide preventive, coordinated, and quality healthcare. With a dedicated nurse practitioner leading a personalized care plan, we strive to improve the health of the communities in which we serve. For more information, please visit www.abilishealth.com. Follow us on LinkedIn.Salary RangeUSD $70,000.00 - $80,000.00 / YearEmployment Type: FULL_TIME

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