About The Position

Help shape smarter, more effective provider networks that expand access, ensure compliance, and support the long-term success of our markets. As a Network Operations Advisor, you play a critical role in designing and sustaining alternative access networks—partnering across the enterprise to translate strategy into execution with precision and care.

Requirements

  • 5+ years of experience in managed healthcare or a related field.
  • 3+ years of experience in provider contracting, provider services, network management, product, or compliance.
  • Demonstrated knowledge of provider networks, network adequacy, and healthcare professional data structures.
  • Strong analytical, critical thinking, and problem-solving skills.
  • Ability to work effectively in a fast-paced, matrixed environment and influence across teams.
  • Proficiency with Excel and data analysis tools.

Nice To Haves

  • Bachelor’s degree or equivalent professional experience.
  • Experience supporting commercial and/or government healthcare products.
  • Familiarity with regulatory requirements related to network adequacy and provider access.
  • Experience with provider contracting systems and data mining.
  • Strong project management and stakeholder communication skills.

Responsibilities

  • Serve as the subject matter expert for alternative access products in assigned markets, including inclusion and exclusion criteria, anchor providers, and network adequacy standards.
  • Evaluate network design options and provide clear, data-driven recommendations that balance access, compliance, and market needs.
  • Lead end-to-end coordination of network builds, reconfigurations, and expansions by translating contracting intent into actionable direction for Network Solutions and Network Operations.
  • Ensure delivery system criteria are interpreted and applied consistently across tools, processes, and products.
  • Partner with Compliance to support regulatory submissions, filings, and ongoing adherence to state and federal requirements.
  • Monitor network adequacy, quality, and performance through ongoing analysis, identifying risks and recommending corrective actions.
  • Manage implementation milestones and timelines, proactively addressing dependencies and maintenance needs.
  • Support post-implementation activities including LocalPlus TrueUps, market sign-offs, and ongoing network integrity efforts.
  • Collaborate with regional and national partners to resolve complex issues, support escalations, and ensure continuity of care.
  • Contribute to training, documentation, and continuous improvement efforts; provide guidance to other Network Operations Advisors as needed.

Benefits

  • Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
  • We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
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