Provider Network Operations in United States at Jobgether
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Job Description
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Provider Network Operations in United States.
This remote opportunity is ideal for a detail-oriented healthcare operations professional who thrives in a fast-paced, data-driven environment. In this role, you will help support and optimize provider network operations by managing provider data, improving service processes, and ensuring operational accuracy across healthcare plans. You will collaborate with cross-functional teams to maintain strong provider relationships, support audits and credentialing activities, and contribute to strategic initiatives tied to network performance and compliance. The position offers a high level of autonomy, exposure to large-scale healthcare data operations, and the opportunity to make a meaningful impact on healthcare service delivery. Candidates who enjoy analytical problem-solving, process improvement, and operational coordination within the healthcare industry will find strong growth potential in this role. This is a fully remote position with a stable schedule and comprehensive benefits available from day one.
- Manage provider network data including demographics, reimbursement rates, contract intent, and operational records to ensure data integrity and compliance.
- Support provider audits, credentialing activities, contract management systems, and provider relations processes across multiple health plans.
- Investigate and resolve provider service issues while coordinating intake and management of provider-related concerns and escalations.
- Analyze healthcare and operational datasets using Excel, SQL, and related tools to support reporting, forecasting, and operational improvements.
- Lead or contribute to mid-to-large-scale operational projects, ensuring timelines, deliverables, and organizational objectives are met.
- Collaborate with internal stakeholders to support departmental strategies, optimize workflows, and improve provider experience.
- Maintain adherence to established operational procedures, compliance standards, and healthcare data governance practices.
- 3+ years of experience in provider network operations, healthcare administration, or related healthcare operations roles.
- Strong analytical and technical skills with experience using Excel, Access, SQL, and other Microsoft applications for data analysis and reporting.
- Experience managing projects or operational initiatives within healthcare or insurance environments.
- Ability to interpret operational data, identify trends, and recommend process improvements.
- Strong organizational skills with the ability to manage multiple priorities independently in a remote environment.
- Excellent communication and collaboration skills with a customer-focused mindset.
- Bachelor’s degree preferred.
- Experience with healthcare datasets, SAS/SPSS, statistical analysis, or financial modeling is considered a plus.
- PMP or PMI-ACP certification is an advantage.
- Must be available to work Eastern Standard Time business hours.
- Competitive salary ranging from $59,300 to $80,900 annually, plus bonus incentive opportunities.
- Comprehensive medical, dental, and vision coverage effective from day one.
- 401(k) retirement savings plan with employer match.
- Paid time off, company holidays, volunteer time, and jury duty pay.
- Tuition assistance and scholarship opportunities for eligible dependents.
- Parental leave and caregiver support programs.
- Career development resources and internal growth opportunities.
- Employee charity matching and recognition programs.
- Fully remote work environment with no regular travel requirements.
- Supplemental insurance options, wellness resources, and additional employee support programs.