Network Management & Provider Relations Specialist

magellanhealth; United States; On-site; USD 46,000 - 68,000; Full time

Benefits offered by this job

Short-term incentives

Comprehensive benefits

Job summary

Magellan Health, Inc. is seeking a Network Management Specialist to support the development and maintenance of the provider network across multiple clients. You will coordinate contracting, deliver provider education, and drive credentialing and quality initiatives.

The role requires independent work, NCQA awareness, and solid MS Office skills (Excel/PowerPoint). A GED/HS is required, with a Bachelor's preferred. Competitive benefits and incentive opportunities available.

Qualifications

• Knowledge of NCQA requirements.
• Ability to work independently and prioritize activities.
• Intermediate knowledge of Microsoft Office Suite, especially Excel.
• Strong PowerPoint presentation skills.
• Minimum of 1 year experience in related position/field.
• GED or High School diploma required; Bachelor's degree preferred.

Responsibilities

• Develop and maintain physician, practitioner, group and facility network delivery systems.
• Coordinate contracting and amendment initiatives.
• Provide issue resolution and complex troubleshooting for providers.
• Conduct provider education and provider relation activities with written materials.
• Perform administrative provider site visits and coordinate report development.
• Coordinate PPRC activities to maintain credentialing and address quality issues.
• Audit provider compliance with Magellan policies and contractual obligations.
• Assist management in drafting and implementing policy changes impacting network management.

Skills

NCQA knowledge

Independent work

Excel

PowerPoint

1 year related experience

Education

GED/High School

Bachelor's degree (preferred)

Tools

Microsoft Office Suite

Job description

Magellan Health, Inc. is seeking a Network Management Specialist to support the development and maintenance of the provider network across multiple clients. You will coordinate contracting, deliver provider education, and drive credentialing and quality initiatives.

The role requires independent work, NCQA awareness, and solid MS Office skills (Excel/PowerPoint). A GED/HS is required, with a Bachelor's preferred. Competitive benefits and incentive opportunities available.