Provider Network & Compliance Specialist

Magellan Health; Newtown (PA); On-site; USD 46,000 - 68,000; Full time

Benefits offered by this job

Health benefits

Job summary

Magellan Health, Inc. is seeking a Network Management Specialist in the United States to support network development and administration across physician, practitioner, group and facility providers.

The role coordinates with multiple business units to ensure network adequacy and service delivery. You will conduct provider education, audits, and report development in alignment with regulatory requirements and contract obligations.

Qualifications

• Knowledge of NCQA requirements.
• Ability to work independently and prioritize activities.
• Intermediate knowledge of Microsoft Office Suite, specifically Excel.
• Strong presentations skills using PowerPoint.
• Minimum of 1 year experience in related position/field.

Responsibilities

• Support network development and maintenance activities across programs.
• Coordinate provider relations and audits to ensure compliance with Magellan policies.
• Assist in contract and amendment initiatives for providers.
• Prepare materials and reports for internal and external stakeholders.
• Support Public Policy Research Center activities and audit processes.

Skills

NCQA requirements

Independent work

Excel

PowerPoint

1 year experience

Education

GED/High School

Bachelor's

Job description

Magellan Health, Inc. is seeking a Network Management Specialist in the United States to support network development and administration across physician, practitioner, group and facility providers.

The role coordinates with multiple business units to ensure network adequacy and service delivery. You will conduct provider education, audits, and report development in alignment with regulatory requirements and contract obligations.