Provider Network Specialist
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AI Summary
The Provider Network Specialist supports contracting activities by preparing, processing, and maintaining provider agreements and related documentation. They manage contracting workflows and coordinate with internal stakeholders to ensure network adequacy and accurate contract records.
Position: Provider Network Specialist
Position Summary
The Provider Network Specialist is responsible for supporting provider contracting activities through the preparation, processing, tracking, and maintenance of provider agreements and related documentation. This position serves as an operational resource within the Network Development department, ensuring timely contract execution, accurate contract records, and effective coordination across internal stakeholders to support network adequacy, market expansion, and provider network objectives.
Primary Roles and Responsibilities:
- Support provider contracting activities through the preparation, processing, execution, and maintenance of provider agreements and amendments.
- Draft, distribute, track, and maintain provider contracts and related documentation in accordance with organizational policies and procedures.
- Manage contracting workflows and contract status within designated systems to ensure visibility, accountability, and timely completion.
- Monitor contracting activities, identify bottlenecks or outstanding items, and coordinate follow-up to support execution timelines.
- Maintain accurate contract records, reports, and supporting documentation to meet operational, regulatory, and audit readiness requirements.
- Support provider onboarding activities through contract-related outreach, document collection, and data validation.
- Support network development and market expansion initiatives through the coordination and execution of contracting activities.
- Participate in special projects and other duties as assigned.
Qualifications
- Associate degree in Business, Healthcare Administration, or a related field preferred; equivalent combination of education and relevant experience will be considered.
- Minimum of 1-3 years of experience in healthcare administration, provider contracting, provider relations, credentialing, network operations, or a related field.
- Strong organizational skills with the ability to manage multiple priorities and deadlines.
- Proficiency in Microsoft Office Suite, including Excel, Word, and Outlook.
- Experience working with databases, tracking systems, or workflow management tools.
- Ability to analyze information, identify issues, and follow through on resolution.
- Strong attention to detail and commitment to accuracy.
- Excellent written and verbal communication skills.
- Ability to work independently and collaboratively in a team environment.
Preferred Skills
- Experience within a managed care, health plan, provider group, or healthcare services environment.
- Familiarity with provider contracting, credentialing, provider onboarding, or network operations.
- Experience using Salesforce, Asana, or similar workflow management systems.
Additional Notes
- Must possess valid driver's license.
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