Provider Network Specialist
Core
Analyze provider demographic, financial, and quality data to drive performance improvements and resolve provider issues.
Role type
Provider Network Specialist (Healthcare Operations)
Builds
Provider engagement strategies, performance reports, and operational workflows for a Medicare Advantage platform.
Domain
Healthcare / Insurance / Data Analytics
Deliverable
dashboards & analysis
Required skills
Data analysis, claims payment process knowledge, provider setup, root cause analysis, contract lifecycle management, Google/MS Suite proficiency
Preferred skills
Medicare Advantage experience, advanced AI tool usage, presentation skills
Responsibilities
Conduct provider performance audits across multiple systems; resolve provider issues directly; manage provider onboarding and contract lifecycles; prepare data and slide decks for monthly performance meetings.
Seniority
Mid-level, hands-on IC
