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Remote Provider Network Development Jobs in Tennessee

xAI

Network Engineer

Memphis, TN · Remote

... provides a reliable, high-performance and secure network behind one of the few products in the ... Liaise with third parties, IT and remote office users to fix and resolve issues * Creation and ...

Revecore

Sr. Network Engineer

Franklin, TN · Remote

$100K - $137K/yr

Remote, with occasional travel Occasional travel to Revecorelocations (Florence KY, Cherry Hill NJ ... Provide tier-3 escalation support and mentor staff. * Participate in on-call rotation and respond ...

TechnologyAdvice

Account Director

Nashville, TN · Remote

Proactively generate new revenue opportunities through cold outreach, personal network development ... LI-Remote Work authorization Employer work visa sponsorship and support are not provided for this ...

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Remote Provider Network Development information

What are some common challenges faced by professionals in Remote Provider Network Development roles and how can they be addressed?

One of the main challenges in Remote Provider Network Development is building strong relationships with providers and stakeholders without regular face-to-face interaction. This requires effective virtual communication skills and the ability to leverage digital collaboration tools. Additionally, navigating differing regulations and provider expectations across regions can be complex, so staying organized and informed about local requirements is crucial. Proactively scheduling regular check-ins and utilizing centralized documentation can help maintain alignment and foster trust among network partners.

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

AspectRemote Provider Network DevelopmentRemote Provider Relations Specialist
Primary FocusBuilding and expanding provider networks, negotiating contractsManaging existing provider relationships, resolving issues
Required CredentialsHealthcare administration, insurance, or related certificationsCustomer service, healthcare administration certifications
Work EnvironmentStrategic planning, cross-department collaborationProvider communication, issue resolution
Industry UsageHealth insurance companies, managed care organizations

Remote Provider Network Development focuses on expanding and negotiating provider networks, while Remote Provider Relations Specialists manage ongoing provider relationships and address issues. Both roles require healthcare or insurance knowledge but differ in their strategic versus operational focus.

What is a Remote Provider Network Development specialist?

A Remote Provider Network Development specialist is responsible for identifying, recruiting, and managing healthcare providers to join a health plan’s network, all while working remotely. They negotiate contracts, ensure providers meet quality standards, and maintain strong relationships to ensure network adequacy. This role often involves analyzing data to identify network gaps and collaborating with internal teams to address member needs. Remote work allows these specialists to connect with providers across various regions without needing to be on-site.

What are the key skills and qualifications needed to thrive as a Remote Provider Network Development professional, and why are they important?

To excel in Remote Provider Network Development, you need expertise in healthcare network management, contract negotiation, and provider relations, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with health plan software, CRM tools, and knowledge of regulatory compliance systems are typically required. Strong communication, relationship-building, and problem-solving skills are essential for establishing and maintaining provider partnerships. These skills ensure effective network expansion, regulatory compliance, and high-quality service for health plan members.
What are the most commonly searched types of Provider Network Development jobs in Tennessee? The most popular types of Provider Network Development jobs in Tennessee are:
What are popular job titles related to Remote Provider Network Development jobs in Tennessee? For Remote Provider Network Development jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Development jobs in Tennessee look for? The top searched job categories for Remote Provider Network Development jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Provider Network Development jobs? Cities in Tennessee with the most Remote Provider Network Development job openings:
Remote Provider Network Development jobs near you
Provider Data Consultant

Provider Data Consultant

BlueCross BlueShield of Tennessee

Chattanooga, TN • On-site, Remote

Full-time

Posted 28 days ago

Job description

We are hiring a Provider Data Consultant at BlueCross BlueShield of Tennessee! In this role, you'll serve as a key partner within our Provider Network organization to support the technical solutions that power how we manage and maintain our network of physicians and hospitals. You'll work closely with business and IT teams to design, enhance, and support reporting, data integrations, and tools that drive provider credentialing, contracting, enrollment and data quality.
This role goes beyond traditional technology - you'll help drive automation and apply AI-enabled solutions to improve efficiency and data quality. You'll build agents, solutions, queries, and optimize data workflows while identifying opportunities to streamline manual processes and improve data quality. We're seeking a data focused consultant and hands-on solution builder who can bring both technical expertise and creative problem-solving to deliver scalable solutions.
To be successful in this role, in addition to the job requirements, you'll bring:
  • Strong SQL with Python or Java to support ETL/ELT data workflows
  • Experience developing reports and dashboards (Power BI, Tableau)
  • Experience building and improving automated processes, including applying AI-enabled capabilities.
  • Experience working with FHIR and APIs and integration tools to support end-to-end data workflows

Important Notes:
  • This is a remote position, but the final round of interviews will take place on-site in our Chattanooga, TN office.
  • Sponsorship is not available for this role.

Job Responsibilities
  • Providing support for the implementation and usage of new or existing analytics applications.
  • Leading the development, testing and implementation of new functions, features and capabilities of analytics applications.
  • Evaluating and scoping user requests for feasibility, costs and time requirements to align with business value and the overall data strategy.
  • Customizing and configuring analytics applications and platforms and optimizing the ETL/ELT process.
  • Responsible for data management, integrations, reporting and quality solutions.
  • May require supervising and administrating staff.

Required Job Qualifications:
Education
  • Bachelor's degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience.

Experience
  • 5 years - Experience working on data management, modeling, and integration required.
  • 5 years - Experience with advance reporting tools required.
  • 3 years - IT lifecycle experience required.
  • 3 years - Proven leadership and/or project management experience required.

Skills/Certifications
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Excellent oral and written communication skills.
  • Strong interpersonal and organizational skills
  • Must be a team player, be organized and have the ability to handle multiple projects
  • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles, and accountability
  • Detail oriented with strong analytic skills
  • Ability to prioritize in an environment of rapid change
  • Able to direct project outcome based on long term business objectives

Number of Openings Available
1
Worker Type:
Employee
Company:
BCBST BlueCross BlueShield of Tennessee, Inc.
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

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