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Provider Network Specialist Jobs (NOW HIRING)

Lowe's

PROvider Network Specialist

Mooresville, NC

$20.67 - $34.52/hr

Your Impact The PROvider Network Specialist is primarily responsible for completing specific activities in support of maintaining the health and accuracy of Lowe's PROvider network. The PROvider ...

Partner with PPHP

Provider Network Specialist

The Provider Network Specialist is responsible for supporting provider contracting activities through the preparation, processing, tracking, and maintenance of provider agreements and related ...

Devoted Health

Provider Network Specialist

$65K - $85K/yr

This highly impactful role will analyze provider demographic information, financial data, quality reports, and special project data. A key responsibility is supporting the performance team in ...

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Provider Network Specialist information

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$37.5K

$80.1K

$115.5K

How much do provider network specialist jobs pay per year?

As of Aug 30, 2026, the average yearly pay for provider network specialist in the United States is $80,093.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,500.00 and $94,000.00 per year, depending on experience, location, and employer.

What is a provider network specialist?

Provider Network Specialists are professionals who manage and maintain relationships between healthcare providers and health insurance companies. They are responsible for recruiting new providers, negotiating contracts, ensuring credentialing requirements are met, and resolving issues related to network participation. Their work helps ensure that patients have access to a broad and high-quality network of doctors, hospitals, and other healthcare professionals. Provider Network Specialists also monitor provider performance and help maintain compliance with regulations and organizational standards.

How does a provider network specialist typically collaborate with healthcare providers and insurance teams?

A Provider Network Specialist regularly communicates with healthcare providers to negotiate contracts, resolve credentialing issues, and ensure compliance with network standards. They also work closely with internal insurance teams, such as claims and customer service departments, to coordinate provider information and address any network gaps. This role often requires balancing provider needs with organizational goals, making strong relationship-building and problem-solving skills essential for success.

What are the key skills and qualifications needed to thrive as a provider network specialist, and why are they important?

To thrive as a Provider Network Specialist, you need a solid understanding of healthcare networks, contract negotiation, and provider relations, often supported by a degree in healthcare administration or a related field. Familiarity with claims processing systems, provider databases, and relevant regulatory compliance tools like HIPAA is typically required. Strong communication, problem-solving, and relationship-building skills help you manage provider partnerships and resolve issues efficiently. These skills are crucial for ensuring a robust, compliant, and cost-effective provider network that meets organizational and patient needs.

What is the difference between Provider Network Specialist vs Claims Processor?

AspectProvider Network SpecialistClaims Processor
CredentialsHealthcare-related certifications, knowledge of insurance policiesBasic insurance or claims processing training
Work EnvironmentHealthcare organizations, insurance companiesInsurance companies, third-party administrators
Industry UsageHigh overlap in healthcare and insurance sectorsPrimarily insurance industry
Job FocusManaging provider networks, contracting, and relationsReviewing and processing insurance claims

The Provider Network Specialist focuses on managing healthcare provider networks, ensuring contracts and relations are maintained, while Claims Processors handle the review and processing of insurance claims. Both roles are essential in healthcare insurance but differ in daily responsibilities and focus areas.

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Provider Network Specialist jobs near you
Infographic showing various Provider Network Specialist job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 4% Part Time, 4% Temporary, and 4% Contract. Highlights an 74% In-person, 4% Hybrid, and 22% Remote job distribution, with an average salary of $80,093 per year, or $38.5 per hour.

Provider Network Specialist

San Francisco, CA • On-site, Remote

Astrana Health, Inc.
See more jobs at Astrana Health, Inc.external

$85K - $92K/yr

Full-time

Posted 6 days ago

Job description

Provider Network Specialist
Department: Provider Relations
Employment Type: Full Time
Location: Remote - NorCal
Reporting To: Tu Nguyen
Compensation: $85,000 - $92,500 / year
Description
The Provider Network Specialist supports the operational administration of the provider network by coordinating provider onboarding, demographic maintenance, network documentation, provider data accuracy, and cross-functional operational workflows. This role works closely with Provider Relations, Contracting, Credentialing, Provider Data Management, and Market Operations to ensure timely and accurate execution of provider network activities.
The Provider Network Specialist plays a key role in maintaining network integrity and supporting efficient provider lifecycle processes throughout the San Jose/Santa Clara County Market.
What You'll Do
Provider Network Administration
  • Coordinate provider onboarding activities with internal departments.
  • Monitor onboarding progress and follow up on outstanding requirements.
  • Assist with provider demographic updates, additions, and terminations.
  • Coordinate provider roster maintenance and network records.

Provider Data Management
  • Maintain provider information within internal databases and tracking systems.
  • Verify provider demographic information for completeness and accuracy.
  • Assist with provider directory maintenance and reconciliation activities.
  • Monitor provider documentation requirements.

Operational Coordination
  • Coordinate provider contracting and credentialing workflow activities.
  • Track provider implementation milestones and required documentation.
  • Monitor operational work queues and assigned tasks.
  • Prepare operational reports and status updates.

Cross-Functional Support
  • Coordinate activities among Provider Relations, Contracting, Credentialing, PDM, Claims, and Operations.
  • Support implementation of provider network initiatives.
  • Assist with audit preparation and documentation requests.

Reporting & Documentation
  • Maintain provider tracking reports.
  • Prepare operational summaries and dashboards.
  • Organize provider files and documentation.
  • Perform other duties as assigned.

Qualifications
Education
  • High school diploma or equivalent required.
  • Equivalent healthcare experience may be substituted.

Experience:
  • 2-3 years of healthcare operations, provider network operations, credentialing, contracting, provider data management, IPA, ACO, MSO, or managed care experience.

You're great for the role if:
  • Experience coordinating provider operational activities.
  • Associate degree preferred.

Knowledge, Skills, and Abilities
  • Knowledge of provider lifecycle processes.
  • Understanding of credentialing, contracting, and provider data management.
  • Strong organizational skills.
  • Strong attention to detail.
  • Ability to manage multiple priorities.
  • Microsoft Office proficiency, including Excel.
  • Strong written and verbal communication skills.
  • Ability to work collaboratively across departments.
  • Ability to travel locally as needed.

Environmental Job Requirements and Working Conditions
  • This is a hybrid position requiring work in both an office environment and provider offices throughout the San Jose / Santa Clara County Market. Regular local travel is required to support provider onboarding, operational coordination, and market activities. The role involves prolonged computer use, frequent interaction with internal stakeholders and provider offices, and occasional attendance at meetings or company events as business needs require.
  • The national target pay range for this role is $85,000 - $92,500 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.comto request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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