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Provider Network Remote Jobs in Michigan (NOW HIRING)

Ascent Global Logistics

Network Engineer

Belleville, MI · Remote

$95K/mo

The experienced Ascent team solves customers' most challenging logistics needs by providing ... The Network Engineer supports branch, Azure cloud, and remote-user connectivity, including routing ...

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 ...

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 ...

Huntington

Network Engineer 3

Detroit, MI · On-site +1

$70K - $140K/yr

Provide Level 3/4 engineering support for the corporate enterprise network. * Verify hardware ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Huntington

Network Engineer 3

Detroit, MI · On-site +1

$70K - $140K/yr

Provide Level 3/4 engineering support for the corporate enterprise network. * Verify hardware ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Next IT

T3 Remote Networking Engineer

Muskegon, MI · On-site +1

More information is available at www.next-it.net This position provides the third level of network support to clients by handling service requests that have been escalated by lower tiers. Support ...

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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 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

Senior Provider Network Operations Data Analyst

Amerihealth Caritas

Southfield, MI • Remote

Full-time

Posted 8 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

128th of 308 rated insurance

Job description

Role Overview: The Senior Provider Network Operations Senior Data Analyst serves as a subject matter expert and key support resource within Provider Network Operations. This role is responsible for training new hires, keeping the team informed and prepared as process or system changes occur, supporting analysts with complex questions, and ensuring accurate, compliant, and timely processing of provider data, rosters, and provider files.

Work Arrangement:

  • Remote - This position is fully remote for candidates residing in Michigan. Occasional travel for meetings, training, or business needs may be required.

Responsibilities:

  • Serve as a go-to subject matter expert for Provider Network Operations processes, including incoming provider data, provider enrollment file completion, and Facets updates.
  • Train new hires and provide ongoing education to analysts to ensure the team remains knowledgeable, consistent, and prepared as business requirements, systems, reporting needs, or processes change.
  • Process and oversee complex provider data files, large rosters, provider enrollments, and related updates while ensuring information is entered accurately and maintained appropriately in Facets and other applicable systems.
  • Monitor analyst workloads, review processing quality, audit analyst work, identify coaching opportunities, and provide guidance to support accuracy, productivity, and adherence to established procedures.
  • Develop new ideas and recommend process improvements that strengthen data quality, streamline enrollment and roster workflows, and improve team effectiveness.
  • Ensure provider data is accurate, complete, and compliant with internal standards, business rules, and reporting requirements; research and resolve discrepancies in a timely and thorough manner.
  • Maintain strong working relationships with provider groups, internal business partners, and cross-functional teams to support provider enrollment, data integrity, issue resolution, and operational needs.
  • User Acceptance Testing (UAT)/Client Review & audit (fee schedule concentration), reviews requests prior to initial submission to EO, and claims post-production
  • Capitation reconciliations, building queries, and comparing membership
  • Internal business report development; engagement with regulatory reporting
  • BAM/claim reporting submission and analysis, depending on complexity
  • Perform additional duties and special projects as assigned.

Education & Experience:

  • Bachelor's degree or equivalent combination of education and relevant work experience.
  • 3 to 5 years of experience in data analysis, healthcare operations, provider network operations, provider data operations, or a related field.
  • Experience with provider enrollment and changes.
  • Experience developing reports and analyzing complex datasets.
  • Managed care or healthcare experience preferred
  • Knowledge of Facets or similar healthcare administration platforms.

Skills & Abilities:

  • Strong analytical and problem-solving skills with the ability to identify trends, root causes, and actionable insights.
  • Proficiency in Microsoft Office Suite, particularly Excel, Word
  • Ability to prioritize and manage multiple competing priorities and projects simultaneously in a fast-paced environment.
  • Strong attention to detail and commitment to data accuracy.
  • Excellent organizational and communication skills.
  • Patience and professionalism when training new hires, coaching analysts, and supporting team members through process or system changes.
  • Flexible, adaptable, and willing to adjust to changing business needs, priorities, and deadlines.
  • Strong team player with a collaborative approach and willingness to support others to meet team and department goals.
  • Ability to work independently while effectively collaborating with cross-functional teams.
  • Experience supporting regulatory reporting and compliance initiatives preferred.

What AmeriHealth Caritas employees say

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