Provider Network Optimization Specialist

Planned Systems International

Northern (KY)

On-site

USD 55,000 - 75,000

Full time

6 days ago

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Benefits offered by this job

Full benefits

401(k) with match

Health Savings Account

Flexible spending account

Paid leave

Job summary

Planned Systems International is seeking a Provider Network Support Specialist to strengthen provider network access, capacity, enrollment, credentialing, compliance, and performance for a federal health program. You will analyze provider data, identify gaps, support enrollment and recruitment, and develop leadership-ready reports.

The ideal candidate is analytical, collaborative, and able to coordinate with clinical, operational, and contractor stakeholders.

Qualifications

Experience supporting provider network operations or related healthcare operations.
Ability to analyze operational data, identify gaps, and translate findings into actions.
Experience developing dashboards, reports, process docs, or briefing materials.
Strong organizational, analytical, problem-solving, and written communication skills.
Ability to manage recurring deliverables, maintain documentation, and track issues.
Ability to handle sensitive healthcare and provider information appropriately.

Responsibilities

Analyze provider rosters and network data to identify gaps in coverage, access, capacity, and credentialing.
Coordinate with network and clinical stakeholders to validate data and track remediation activities.
Develop and maintain provider capacity analyses, enrollment dashboards, status reports, and leadership briefing materials.
Review enrollment and credentialing workflows, metrics, delays, and compliance concerns; recommend improvements.
Support provider recruitment, communications, training, and credentialing prioritization.