Innovative Systems Group
Overview
Job Title: Provider Network Consultant Location: Alb NM or
Chicago, IL
or Oklahoma OK | Remote but training will be onsite Duration: November 2025 to February 2027 (possible extension) Pay: $21.00/hr on W2 This position is responsible for analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. This position is responsible for contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business. This role involves supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow. This position includes assisting management in familiarizing and training team members with the various business rules in network contracting and credentialing across all lines of business. In addition is responsible for identifying gaps in processes and suggesting process improvement strategies.
Responsibilities Analyze, research, and apply business rules to provider data requests (adds/deletes/changes) used for claims processing, membership assignment, and directory purposes. Manage contracting, credentialing, and maintenance of Facility/Professional provider data to support marketing and network contracting across lines of business. Support implementation of special projects, track project phases, and manage workflow. Assist management in training team members on network contracting and credentialing rules. Identify process gaps and suggest improvement strategies.
Required Job Qualifications
HS Diploma/GED (education verification required) plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
Written and verbal communication skills, including interpersonal skills.
Skills to develop training materials and act as an advisor to staff.
Experience and proficiency in Microsoft Office software products including analytical tools. Experience developing reports.
Preferred Job Qualifications
Subject Matter Expert for the Professional Provider Credentialing Process.
2 years of experience with current government sponsored health insurance networks.
Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics.
Seniority level
Entry level
Employment type
Full-time
Job function
Administrative
Industries
Hospitals and Health Care
#J-18808-Ljbffr
Job Title: Provider Network Consultant Location: Alb NM or
Chicago, IL
or Oklahoma OK | Remote but training will be onsite Duration: November 2025 to February 2027 (possible extension) Pay: $21.00/hr on W2 This position is responsible for analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. This position is responsible for contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business. This role involves supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow. This position includes assisting management in familiarizing and training team members with the various business rules in network contracting and credentialing across all lines of business. In addition is responsible for identifying gaps in processes and suggesting process improvement strategies.
Responsibilities Analyze, research, and apply business rules to provider data requests (adds/deletes/changes) used for claims processing, membership assignment, and directory purposes. Manage contracting, credentialing, and maintenance of Facility/Professional provider data to support marketing and network contracting across lines of business. Support implementation of special projects, track project phases, and manage workflow. Assist management in training team members on network contracting and credentialing rules. Identify process gaps and suggest improvement strategies.
Required Job Qualifications
HS Diploma/GED (education verification required) plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
Written and verbal communication skills, including interpersonal skills.
Skills to develop training materials and act as an advisor to staff.
Experience and proficiency in Microsoft Office software products including analytical tools. Experience developing reports.
Preferred Job Qualifications
Subject Matter Expert for the Professional Provider Credentialing Process.
2 years of experience with current government sponsored health insurance networks.
Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics.
Seniority level
Entry level
Employment type
Full-time
Job function
Administrative
Industries
Hospitals and Health Care
#J-18808-Ljbffr