Provider Network Specialist III

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Provider Network Specialist III based in United States.

This role plays a key part in strengthening provider networks and ensuring individuals have access to high-quality healthcare and support services. The position focuses on provider relationship management, network operations, and coordination efforts that improve service delivery across communities. You will collaborate with internal teams and external partners to maintain accurate provider information, resolve challenges, and support organizational goals. This opportunity is ideal for a detail-oriented professional who enjoys building partnerships and improving healthcare access. The role combines operational expertise, communication skills, and problem-solving abilities within a mission-driven environment. You will contribute to initiatives that help create stronger systems of care and better outcomes for individuals and families.

Accountabilities:: As a Provider Network Specialist III, you will support provider network operations by managing relationships, ensuring compliance, and improving network effectiveness.

Manage provider network activities, including provider onboarding, maintenance, communication, and ongoing relationship support.

Serve as a primary point of contact for assigned providers, addressing inquiries, resolving issues, and ensuring effective collaboration.

Review and maintain provider records, contracts, and network documentation to ensure accuracy and compliance.

Coordinate with internal departments to support provider operations, credentialing processes, and network improvement initiatives.

Analyze provider network data, identify trends, and provide recommendations to improve access, quality, and operational performance.

Support the implementation of network strategies that align with healthcare service needs and organizational objectives.

Assist with provider education, communication campaigns, and updates related to policies, procedures, and operational changes.

Monitor provider performance, compliance requirements, and service delivery standards while escalating issues when necessary.

Participate in audits, reporting activities, and process improvement efforts related to provider network management.

Build strong partnerships with providers and stakeholders to support effective healthcare delivery across the service area.

Requirements:

The ideal candidate brings experience in provider network operations, healthcare administration, and relationship management, along with strong analytical and communication skills.

Experience working in healthcare administration, managed care, provider relations, network management, or a related field.

Strong understanding of provider network operations, healthcare systems, and managed care processes.

Experience managing provider relationships and collaborating with healthcare professionals, organizations, and internal stakeholders.

Ability to analyze data, identify operational challenges, and recommend effective solutions.

Strong organizational skills with the ability to manage multiple priorities, deadlines, and projects.

Excellent written and verbal communication skills with the ability to communicate effectively with diverse audiences.

Strong attention to detail and ability to maintain accurate records and documentation.

Ability to work independently while collaborating effectively in a remote environment.

Experience with healthcare compliance requirements, provider contracts, or credentialing processes is preferred.

Knowledge of behavioral health, substance use services, intellectual/developmental disabilities, or related healthcare programs is a plus.

Benefits:

Salary range of $68,890 - $92,138.

Remote work opportunity within North Carolina.

Opportunity to support meaningful healthcare programs that improve access and outcomes for individuals and families.

Collaborative and mission-driven work environment.

Professional development and career growth opportunities.

Comprehensive employee benefits package, including healthcare and wellness support.

Opportunity to contribute to innovative approaches in managed care and provider network improvement.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether?    Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.     #LI-CL1