Administrator, Provider Network
About The Position
The Provider Network Administrator is responsible for negotiating, administering, and maintaining contracts and relationships (i.e. Primary Care Physician (PCP), specialist, ancillary providers, hospitals) to ensure a high-quality, cost-effective, and compliant provider network. This role supports managed care growth initiatives and organizational goals. Key responsibilities include identifying and onboarding new providers, ensuring regulatory compliance, and fostering strong partnerships with existing partners. The Provider Network Administrator will also assist in tracking progress, enhancing brand visibility, and supporting efforts to secure new contracts. Success in this role requires strong communication skills, attention to detail, and a solid understanding of the healthcare industry.
Requirements
- Bachelor's degree in a related field with 2 years of relevant experience (i.e. provider contracting, contract interpretation, negotiation, client relations) or 3 years of relevant experience in lieu of a degree.
- Strong communication skills.
- Attention to detail.
- Solid understanding of the healthcare industry.
Nice To Haves
- Healthcare experience in a Managed Care setting or with a physician group, clinical-based organization, and/or in a hospital/facility setting.
- Experience with Medicaid, Medicare Advantage, or Commercial provider networks.
- Experience with contract lifecycle management systems and provider databases.
- Experience with provider reimbursement methodologies (e.g., fee-for-service, capitation, value-based models).
- Experience with healthcare regulatory requirements (e.g., CMS, DHCS, DMHC, NCQA) related to provider networks.
Responsibilities
- Negotiating, administering, and maintaining contracts and relationships with providers (PCP, specialist, ancillary, hospitals).
- Ensuring a high-quality, cost-effective, and compliant provider network.
- Supporting managed care growth initiatives and organizational goals.
- Identifying and onboarding new providers.
- Ensuring regulatory compliance.
- Fostering strong partnerships with existing providers.
- Assisting in tracking progress.
- Enhancing brand visibility.
- Supporting efforts to secure new contracts.
Benefits
- Medical, Dental and Vision insurance
- 403(b) Retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career Advancement & Development opportunities
- Paid Time Off & Holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
