Hybrid Provider Network Operations Specialist II

CareAllies Inc.; United States; Hybrid; USD 48,000 - 86,000; Full time

Job summary

CareAllies, based in Philadelphia, seeks a hybrid Provider Relations specialist responsible for HEDIS quality measures, wellness visits attestations, and data integrity. You will engage with providers, manage contracts and credentialing, and coordinate with internal teams.

The role emphasizes independent initiative, strong communication, and analytical skills to support value-based care. Travel to provider sites and office-based work three days a week expected.

Qualifications

• Bachelor's degree or 4 years of health care industry experience.
• 2 years of experience with Provider Network contracting and credentialing systems.
• Strong written and verbal communication skills.
• Analytical and quantitative skills.
• Ability to take initiative and work independently.

Responsibilities

• Overall performance and quality measures, including HEDIS and Medicare wellness attestations.
• Manage provider relationships and data integrity to support value-based care initiatives.
• Support network operations, cross-functional collaboration, and stakeholder engagement.
• Lead internal provider meetings and problem-solving for provider performance.

Skills

Written and verbal communication

Analytical and quantitative skills

Independent initiative

Education

Bachelor's degree or 4 years health care experience

Tools

Provider Network contracting systems

Population Health Management applications

Microsoft Office (Excel, PowerPoint)

Job description

CareAllies, based in Philadelphia, seeks a hybrid Provider Relations specialist responsible for HEDIS quality measures, wellness visits attestations, and data integrity. You will engage with providers, manage contracts and credentialing, and coordinate with internal teams.

The role emphasizes independent initiative, strong communication, and analytical skills to support value-based care. Travel to provider sites and office-based work three days a week expected.