Provider Network Specialist

Astrana Health, Inc.•San Francisco, CA

22h•$85,000 - $92,500•Hybrid

About The Position

The Provider Network Specialist supports the operational administration of the provider network by coordinating provider onboarding, demographic maintenance, network documentation, provider data accuracy, and cross-functional operational workflows. This role works closely with Provider Relations, Contracting, Credentialing, Provider Data Management, and Market Operations to ensure timely and accurate execution of provider network activities. The Provider Network Specialist plays a key role in maintaining network integrity and supporting efficient provider lifecycle processes throughout the San Jose/Santa Clara County Market.

Requirements

High school diploma or equivalent required.
Equivalent healthcare experience may be substituted.
2-3 years of healthcare operations, provider network operations, credentialing, contracting, provider data management, IPA, ACO, MSO, or managed care experience.
Experience coordinating provider operational activities.
Knowledge of provider lifecycle processes.
Understanding of credentialing, contracting, and provider data management.
Strong organizational skills.
Strong attention to detail.
Ability to manage multiple priorities.
Microsoft Office proficiency, including Excel.
Strong written and verbal communication skills.
Ability to work collaboratively across departments.

Nice To Haves

Associate degree preferred.
Ability to travel locally as needed.

Responsibilities

Coordinate provider onboarding activities with internal departments.
Monitor onboarding progress and follow up on outstanding requirements.
Assist with provider demographic updates, additions, and terminations.
Coordinate provider roster maintenance and network records.
Maintain provider information within internal databases and tracking systems.
Verify provider demographic information for completeness and accuracy.
Assist with provider directory maintenance and reconciliation activities.
Monitor provider documentation requirements.
Coordinate provider contracting and credentialing workflow activities.
Track provider implementation milestones and required documentation.
Monitor operational work queues and assigned tasks.
Prepare operational reports and status updates.
Coordinate activities among Provider Relations, Contracting, Credentialing, PDM, Claims, and Operations.
Support implementation of provider network initiatives.
Assist with audit preparation and documentation requests.
Maintain provider tracking reports.
Prepare operational summaries and dashboards.
Organize provider files and documentation.
Perform other duties as assigned.