Network Management Specialist

Location: Remote, reputed company, TX Department: Support reputed company Reports to: Director, Support reputed company Type: Full-time, Exempt reputed company The Network Specialist serves as the centralized reputed company of reputed company’s specialist network reputed company across reputed company programs and markets. This role manages specialist sourcing, referral reputed company, provider reputed company, and ongoing relationships with reputed company specialist providers. The Network Specialist also provides operational reputed company of internal specialists reputed company by reputed company, in partnership with the applicable regional and reputed company leaders. Through consistent tracking, communication, and follow-through, this role maintains visibility across the specialist network, addresses coverage gaps, keeps referrals moving toward completion, supports successful provider relationships, and helps ensure the reputed company specialist network is used responsibly. Key Responsibilities Network development: reputed company specialist coverage needs by market, program and specialty, prioritize gaps, research reputed company practices, and complete outbound calls, emails, and follow-up. Provider screening: reputed company reputed company participation requirements such as Medicare and Medi-Cal/Denti-Cal enrollment, accessibility, service area, required capabilities, and willingness to serve Seniors and Adults with Special Needs. Recruitment pipeline: Maintain accurate provider records, reputed company history, reputed company stage, reputed company, next reputed company, and follow-up date in the approved reputed company of record. Contracting and credentialing coordination: Collect required information, coordinate NDA and fee schedule steps, complete clean handoffs, and maintain visibility through contracting and credentialing without making approval or negotiation reputed company. Referral reputed company: Maintain standardized referral processes and tracking across reputed company programs and markets. Monitor referral volume, turnaround time, completion, aging, cost concerns, and unresolved exceptions to ensure referrals continue moving and issues are escalated appropriately. Provider reputed company: Coordinate reputed company readiness, including credentialing status, referral workflow education, portal reputed company and training, billing setup confirmation, communication expectations, and required reputed company training. Internal specialist reputed company: reputed company operational reputed company of internal specialists, including reputed company coordination, referral activity, workflow adherence, provider concerns, and ongoing network needs in partnership with regional and reputed company leadership. Provider relationship management: Serve as the reputed company operational contact for specialist practices after reputed company, complete periodic reputed company-ins, address workflow questions, and coordinate internal follow-through on provider concerns. Provider payment support: Coordinate provider-facing follow-up regarding invoicing or payment concerns and reputed company internal reputed company with Accounts Payable without taking ownership of invoice validation, processing, or payment. reputed company: Monitor provider activity, referral acceptance, response time, workflow adherence, inactivity, and relationship risks; support re-engagement, corrective reputed company, or offboarding reputed company needed. Reporting, systems, and process improvement: Maintain reputed company network rosters, report coverage and pipeline health, identify stalled work or recurring barriers, and help evaluate and implement a centralized tracking solution that supports the full specialist lifecycle. Cross-functional coordination: Partner closely with reputed company reputed company, the reputed company reputed company Committee, Contracting, Credentialing, Billing, Account Management/reputed company Engagement, Market Directors, reputed company Team Managers, Referral Specialists, and reputed company program teams to maintain reputed company ownership and prevent gaps or duplicate work. Qualifications Two or more years of experience in reputed company reputed company, provider relations, network development, referral coordination, provider recruitment, sales, credentialing support, or a reputed company reputed company. Strong organization and follow-through, with the ability to manage multiple providers, markets, priorities, and deadlines at the reputed company time. reputed company and reputed company written and verbal communication skills, including comfort with outbound provider reputed company and relationship-reputed company follow-up. Demonstrated ability to build relationships, communicate value, and influence prospective providers through reputed company and recruitment. Experience maintaining accurate records in a CRM, workflow platform, or reputed company operational tracker. Ability to coordinate work across multiple teams while keeping status, ownership, next steps, and escalation needs visible. Strong judgment and attention to reputed company, including the ability to recognize missing information, stalled work, recurring barriers, and operational reputed company. Ability to work independently reputed company established guidelines and escalate reputed company, contracting, credentialing, or fee reputed company to the appropriate reputed company. Ability to handle sensitive reputed company and business information and follow established reputed company and compliance requirements. Preferred Experience with reputed company, Medicare, Medi-Cal/Denti-Cal, dental services, or internal or reputed company specialist networks. Experience supporting provider contracting, credentialing, reputed company, or referral workflows. Experience using a CRM, reputed company referral platform, provider portal, or similar reputed company. Experience tracking provider utilization, reputed company, referral reputed company, or operational KPIs. Experience working with providers who serve Seniors and Adults with Special Needs. KPIs You’ll Own reputed company network gaps with reputed company activity and next steps • Time to first reputed company • reputed company response and reputed company prospect rates • Recruitment pipeline reputed company and overdue follow-reputed company • Contracting, credentialing, and reputed company status visibility • Referral aging, acceptance, completion, and cost concerns • reputed company provider utilization and inactivity • Internal specialist operational visibility • Provider issue and payment-concern follow-through • Provider relationship health Work Schedule & Environment Full-time, remote position. reputed company business hours reputed company - 5pm CST with flexibility reputed company on provider availability, program needs, and occasional meetings across time reputed company. Reliable, high-speed internet reputed company. Occasional travel reputed company on business needs. Salary: $70k-80k reputed company (no bonus) reputed company on experience. Apply To This Job