Medix™
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$70,000.00/yr - $75,000.00/yr We are seeking a Provider Network Specialist to serve as the primary liaison between the health plan and its network of healthcare providers. This role focuses on building strong provider relationships, supporting on-boarding and education, and ensuring network adequacy and compliance. The ideal candidate is comfortable working autonomously, traveling within their territory, and collaborating cross-functionally to support high-quality care delivery and a positive provider experience. Key Responsibilities
Serve as the main point of contact for prospective and existing providers, addressing operational, contractual, and policy-related inquiries Guide providers through the full on-boarding life cycle, including application, credentialing, and contracting Conduct in-person site visits with providers in accordance with plan standards Lead new provider orientations and deliver ongoing training to ensure understanding of plan policies, programs, and contractual requirements Build and maintain strong relationships with providers, office staff, and key internal stakeholders Maintain an accurate and up-to-date directory of provider contacts across departments such as Credentialing, Claims, Contracting, Quality, Managed Care, and Population Health Manage a designated geographic territory, collaborating closely with internal care centers and marketing teams Schedule and conduct routine office visits with high-volume providers to support engagement and performance goals Resolve provider issues related to credentialing, reimbursement, claims, access standards, eligibility, and reporting requirements Document provider concerns accurately and ensure timely resolution in alignment with plan policies Coordinate cross-departmental efforts to address complex provider issues and identify trends for process improvement Partner with marketing and sales teams on outreach initiatives to expand the provider network and increase brand visibility Develop and present analytical reports assessing network adequacy, access gaps, and provider availability Monday–Friday, 9:00 AM–5:00 PM In-office in NYC on Tuesdays and Thursdays Remaining days are remote or spent onsite with providers Travel required throughout New York and Connecticut Autonomous scheduling with flexibility to arrange provider visits independently Must-Have Qualifications
Must reside in the Tri-State area 3+ years of experience working with health insurance and/or provider relations (must have direct provider-facing experience) Associate’s or Bachelor’s degree Valid driver’s license and access to a personal vehicle Ability to travel to provider sites in NY and CT 1–2 days per week Strong presentation and communication skills Nice-to-Have Qualifications
Experience conducting provider training or orientations Familiarity with credentialing, claims, and managed care operations Comfort working in a fast-paced, relationship-driven environment What We Offer
Strong, collaborative team culture with regular team events Clear opportunities for growth and advancement Seniority level
Associate Employment type
Full-time Job function
Other Industries
Insurance
#J-18808-Ljbffr
$70,000.00/yr - $75,000.00/yr We are seeking a Provider Network Specialist to serve as the primary liaison between the health plan and its network of healthcare providers. This role focuses on building strong provider relationships, supporting on-boarding and education, and ensuring network adequacy and compliance. The ideal candidate is comfortable working autonomously, traveling within their territory, and collaborating cross-functionally to support high-quality care delivery and a positive provider experience. Key Responsibilities
Serve as the main point of contact for prospective and existing providers, addressing operational, contractual, and policy-related inquiries Guide providers through the full on-boarding life cycle, including application, credentialing, and contracting Conduct in-person site visits with providers in accordance with plan standards Lead new provider orientations and deliver ongoing training to ensure understanding of plan policies, programs, and contractual requirements Build and maintain strong relationships with providers, office staff, and key internal stakeholders Maintain an accurate and up-to-date directory of provider contacts across departments such as Credentialing, Claims, Contracting, Quality, Managed Care, and Population Health Manage a designated geographic territory, collaborating closely with internal care centers and marketing teams Schedule and conduct routine office visits with high-volume providers to support engagement and performance goals Resolve provider issues related to credentialing, reimbursement, claims, access standards, eligibility, and reporting requirements Document provider concerns accurately and ensure timely resolution in alignment with plan policies Coordinate cross-departmental efforts to address complex provider issues and identify trends for process improvement Partner with marketing and sales teams on outreach initiatives to expand the provider network and increase brand visibility Develop and present analytical reports assessing network adequacy, access gaps, and provider availability Monday–Friday, 9:00 AM–5:00 PM In-office in NYC on Tuesdays and Thursdays Remaining days are remote or spent onsite with providers Travel required throughout New York and Connecticut Autonomous scheduling with flexibility to arrange provider visits independently Must-Have Qualifications
Must reside in the Tri-State area 3+ years of experience working with health insurance and/or provider relations (must have direct provider-facing experience) Associate’s or Bachelor’s degree Valid driver’s license and access to a personal vehicle Ability to travel to provider sites in NY and CT 1–2 days per week Strong presentation and communication skills Nice-to-Have Qualifications
Experience conducting provider training or orientations Familiarity with credentialing, claims, and managed care operations Comfort working in a fast-paced, relationship-driven environment What We Offer
Strong, collaborative team culture with regular team events Clear opportunities for growth and advancement Seniority level
Associate Employment type
Full-time Job function
Other Industries
Insurance
#J-18808-Ljbffr