Provider Network Manager — Remote & Market Expansion

American Health Communities; Franklin (TN); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Affordable Medical/Dental/Vision

Paid time off & holidays

TeleDoc access

Disability plans

EAP

401K with company match

Referral bonus

Job summary

American Health Plans, a division of American Health Partners Inc., seeks a Provider Network Manager in Franklin, TN. You will establish CMS-compliant, cost-effective provider networks and negotiate agreements with healthcare providers across assigned markets.

You will maintain relationships with providers, monitor network adequacy, and support expansion into additional states. Strong negotiation and communication skills are essential for success.

Qualifications

• Bachelor’s degree or equivalent work experience.
• 5+ years in managed care/network development or related field.

Responsibilities

• Establish CMS-compliant, cost-effective provider networks in assigned markets.
• Negotiate agreements with providers and vendors.
• Maintain positive relationships with contracted providers.
• Monitor network adequacy and report material changes.
• Support market expansions and new market implementations.
• Complete corporate assignments including compliance training.

Skills

Negotiation

Provider network development

CMS compliance

Credentialing

Communication

Time management

Education

Bachelor’s degree or equivalent

Tools

Credentialing systems

CMS standards

Job description

American Health Plans, a division of American Health Partners Inc., seeks a Provider Network Manager in Franklin, TN. You will establish CMS-compliant, cost-effective provider networks and negotiate agreements with healthcare providers across assigned markets.

You will maintain relationships with providers, monitor network adequacy, and support expansion into additional states. Strong negotiation and communication skills are essential for success.