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Provider Network Remote Jobs in Michigan (NOW HIRING)

Nityo Infotech

Network Cloud Engineer

Ann Arbor, MI · Remote

Remote- Michigan Duration: Long Term This role will provide design and architecture for the network infrastructure and services (InterConnect, Bastion Services, VPC Peering, etc.) for GCP cloud ...

Nityo Infotech

Network Cloud Engineer

Ann Arbor, MI · On-site +1

Remote- Michigan Duration: Long Term • This role will provide design and architecture for the network infrastructure and services (InterConnect, Bastion Services, VPC Peering, etc.) for GCP cloud ...

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Provider Network Remote information

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

AspectProvider Network RemoteProvider Relations Specialist
CredentialsTypically requires healthcare or insurance certificationsSimilar certifications, often including healthcare administration
Work EnvironmentRemote, independent work with healthcare providersOffice or remote, focusing on communication with providers
Industry UsageUsed in health insurance and managed care organizationsCommon in insurance companies and healthcare networks
Search & Comparison IntentUnderstanding remote provider network rolesLearning about provider relations and communication roles

Provider Network Remote and Provider Relations Specialist roles share similar credentials and industry settings, but differ mainly in focus. Provider Network Remote emphasizes managing provider networks remotely, while Provider Relations Specialists focus on building relationships and communication with providers, often in an office setting.

What are the most commonly searched types of Provider Network jobs in Michigan? The most popular types of Provider Network jobs in Michigan are:
What are popular job titles related to Provider Network Remote jobs in Michigan? For Provider Network Remote jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Provider Network Remote jobs in Michigan look for? The top searched job categories for Provider Network Remote jobs in Michigan are:
What cities in Michigan are hiring for Provider Network Remote jobs? Cities in Michigan with the most Provider Network Remote job openings:
Provider Network Remote jobs near you
Supervisor Provider Network Operations

Supervisor Provider Network Operations

AmeriHealth Caritas

Southfield, MI • On-site, Remote

$78K - $104K/yr

Full-time

Posted 6 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 70 frontline employees who took The Breakroom Quiz

85th of 277 rated insurance

Job description

Role Overview: The Provider Network Operations Supervisor supports the daily operations of the Provider Network Operations team by overseeing staff performance, ensuring operational efficiency, and maintaining compliance with internal policies and contractual requirements.
Work Arrangement:
  • Fully remote candidate must be located in Michigan (MI)
  • Requires reliable high-speed internet (minimum 50 Mbps download / 5 Mbps upload)
  • Internet reimbursement may be available where required by law or contract

Responsibilities:
  • Supervise, coach, and monitor staff performance to ensure quality and timely completion of work
  • Support the Manager in implementing departmental initiatives and process improvements
  • Ensure operational processes align with internal policies, contractual obligations, and service level agreements (SLAs)
  • Oversee and support the resolution of provider inquiries and complaints, ensuring timely and effective outcomes
  • Monitor provider data maintenance and/or claims-related activities, providing feedback and recommendations for improvement
  • Research and resolve complex claims issues and operational discrepancies
  • Identify operational challenges and recommend solutions to improve performance and compliance
  • Participate in special projects and perform additional duties as assigned

Education & Experience:
  • Associate degree required or equivalent combination of education and relevant work experience
  • 1 to 3 years of supervisory or leadership experience preferred
  • Experience in managed care or a healthcare environment preferred
  • Knowledge of claims processing, coding, payment, and/or provider data operations strongly preferred
  • Familiarity with Medicaid reimbursement methodologies preferred

Skills & Abilities:
  • Strong leadership and team development capabilities
  • Knowledge of healthcare operations, particularly claims and provider data
  • Analytical and problem-solving skills with attention to detail
  • Ability to manage multiple priorities in a fast-paced environment
  • Strong communication and interpersonal skills
  • Ability to identify process improvement opportunities and drive change

What AmeriHealth Caritas employees say

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