Network Quality & Provider Relations Manager

Medrisk Llc; Conshohocken (Montgomery County); Hybrid; USD 110,000 - 160,000; Full time

Job summary

Medrisk LLC in Conshohocken, PA, seeks a Manager of Network Quality & Management to lead a clinical and administrative team, build relationships with clinicians and providers, ensure quality standards and regulatory compliance, and drive performance improvements.

The role blends clinical leadership with provider relations, requiring analytics, strategic oversight, and travel to expand the network; remote work flexibility is supported.

Qualifications

• Bachelor’s degree required or BA, BSN, or Current RN licensure in New Jersey, or Family Nurse Practitioner (FNP) / Acute Care Nurse Practitioner (ACNP) license/certification
• 6+ years of provider relations or clinical nursing experience in direct patient care or clinical leadership roles
• 3+ years of team leadership, clinical management, or quality improvement experience within a healthcare setting
• Proven ability to establish and monitor key performance indicators
• Proven ability to meet deadlines and manage competing priorities
• Proven ability to influence course of action and build consensus across teams
• Intermediate proficiency with Microsoft Word, Excel, and PowerPoint
• Excellent organizational and project management skills
• Strong verbal and written communication abilities

Responsibilities

• Develop and implement quality standards and network management strategies that drive clinician engagement, network growth, and retention across current and prospective service areas
• Build and maintain trust-based relationships with clinicians, clinical leaders, and healthcare providers; serve as a liaison to understand practice patterns, clinical concerns, and needs
• Partner with clinicians and clinical leaders to establish clinical quality improvement initiatives, benchmark clinical performance against best practices and standards, and identify gaps in clinical capabilities or service offerings
• Conduct regular onsite clinical assessments with providers, utilizing clinical expertise and performance data to determine priority visits based on quality metrics, clinical outcomes, utilization patterns, member experience, and regulatory compliance indicators
• Represent the organization as a clinical subject matter expert in provider meetings, regulatory forums, clinical conferences, and key healthcare events; position the organization for network expansion into new service areas and states (minimum 25% travel)
• Lead and facilitate clinical meetings with providers, medical groups, clinical advisory committees, and regulatory representatives using clinical knowledge to drive discussions
• Attend key provider conferences and advisory committees to demonstrate leadership and subject matter expertise
• Monitor and drive improvement in clinical quality metrics, clinical outcomes, and clinician satisfaction across the network; establish clinical performance dashboards and quality benchmarks aligned with industry standards and regulatory requirements

Skills

Provider relations

Clinical nursing

Team leadership

Regulatory compliance

Quality improvement

Data analysis

Communication

Microsoft Word

Excel

PowerPoint

Education

Bachelor’s degree

RN licensure in New Jersey

FNP/ACNP license/certification

MSN/MBA/MHA (preferred)

Tools

Microsoft Word

Excel

PowerPoint

Job description

Medrisk LLC in Conshohocken, PA, seeks a Manager of Network Quality & Management to lead a clinical and administrative team, build relationships with clinicians and providers, ensure quality standards and regulatory compliance, and drive performance improvements.

The role blends clinical leadership with provider relations, requiring analytics, strategic oversight, and travel to expand the network; remote work flexibility is supported.