Provider Network Specialist

Personify Health

105d • $70,000 - $80,000

About The Position

Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Requirements

• Bachelor's degree in Healthcare Administration, Business, or related field (equivalent work experience considered)
• 2-4 years experience in provider network management, provider relations, healthcare operations, or client management, preferably within TPA, health plan, or health system environment.
• Demonstrated experience with various provider reimbursement models including fee-for-service.
• Strong understanding of value-based care concepts (ACOs, Clinically Integrated Networks).
• Proven ability to analyze healthcare data (claims, provider, eligibility) to identify trends and conduct root-cause analysis.

Nice To Haves

• Exceptional ability to build rapport and establish trust with dedicated clients, providers, and internal colleagues.
• Strong problem-solving skills with talent for translating complex data into clear, actionable insights and solutions.
• Deep commitment to client service and partnership with ability to act as dedicated advocate and resource.
• Outstanding written and verbal skills for presenting complex information clearly to diverse audiences.
• Self-starter who can work independently, take ownership of client relationships, and navigate ambiguity in dynamic environments.
• Proficient in Microsoft Office Suite (especially Excel) with comfort learning new claims and provider management software.

Responsibilities

• Serve as primary operational point of contact for health system client, building trusted, collaborative relationships that drive mutual success.
• Develop and maintain performance dashboards while delivering regular, actionable insights to client and internal leadership for strategic decision-making.
• Oversee provider data accuracy and timely updates to support seamless claims processing and provider directory reliability.
• Lead research and resolution of provider and member escalations, including network status, fee schedules, and claims payment challenges.
• Perform deep-dive investigations into specific claim examples, collaborating with providers on billing practices and internal teams on configuration issues.
• Function as go-to internal expert for all operational and contractual nuances of dedicated health system network.

Benefits

• Comprehensive medical and dental coverage through our own health solutions.
• Mental health support and wellness programs designed by experts.
• Flexible work arrangements.
• Retirement planning support.
• Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection.
• Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage.
• Professional development opportunities and clear career progression paths.
• Mentorship from industry leaders.
• Learning budget to invest in skills.
• Competitive base salary that rewards your success.
• Unlimited PTO policy.
• Benefits effective day one.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees