Provider Network Specialist

Devoted Health • Waltham, MA

1d • Remote

About The Position

This highly impactful role will analyze provider demographic information, financial data, quality reports, and special project data. A key responsibility is supporting the performance team in preparing for and executing monthly provider performance meetings, ensuring insights are actionable and aligned with performance goals. The ideal candidate brings a strong understanding of data analysis, claims payment processes, provider setup, and root cause analysis, with a clear focus on improving provider engagement. Success in this role requires the ability to work both independently and collaboratively, strong organizational discipline, and a results-driven mindset.

Requirements

• A minimum of 3 years of healthcare experience, preferably in Medicare Advantage or similar environments
• 5 years of direct provider interaction experience
• Demonstrated ability to manage detailed, performance-driven work
• Proficiency in Google or MS Suite Workspace applications.
• Experience in claims research, provider setup, root cause analysis, and process improvement with a focus on provider engagement
• Strong written and oral communication skills
• MUST BE LOCATED IN GEORGIA

Nice To Haves

• Organized and detail oriented
• Ability to effectively manage competing priorities and ambiguity is essential
• Ability to gather, read, analyze, and interpret complex data and create accurate meaningful information for data reporting
• Ability to facilitate meetings, and make presentations before groups of management and staff.

Responsibilities

• Conduct in-depth audits across provider performance systems, including Orinoco (demographics and fee schedules), online search tools, print directories, Looker reports, and claims payment processes.
• Evaluate data through a performance lens to identify gaps, inefficiencies, and root causes impacting provider performance.
• Deliver clear, actionable insights and partner with the performance team to implement improvements that enhance overall provider effectiveness.
• Support Field Performance initiatives by engaging directly with providers to resolve provider-related issues.
• Ensure timely resolution and clear documentation.
• Manage the full contract lifecycle while maintaining a focus on onboarding high-performing providers and improving overall engagement.
• Partner with Performance Managers to prepare for monthly performance meetings by pulling data by leveraging AI-driven prompts with a strong emphasis on advanced AI tools and preparing slide decks and follow up items from previous meetings.

Benefits

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed