Provider Network Support

Advanced Technologies and Laboratories International, Inc.; United States; Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Healthcare coverage

Dental

Vision

Short-term disability

Long-term disability

Life insurance

AD&D coverage

Legal services

Identity theft protection

Flexible spending account

Health Savings Account

401(k) with employer match

Tuition reimbursement

Professional development

Job summary

Planned Systems International is seeking a Provider Network Support Specialist to strengthen provider network access, capacity, enrollment, credentialing, and compliance for a federal healthcare program.

You will analyze provider network data, identify gaps, support enrollment and recruitment activities, and develop reports and recommendations for program leadership. Collaboration with clinical and contractor stakeholders is essential.

Qualifications

• Experience supporting provider network operations, enrollment, credentialing, or related healthcare operations.
• Ability to analyze operational data, identify gaps, and translate findings into actionable recommendations.
• Experience developing dashboards, reports, process documentation, or briefing materials.
• Strong organizational, analytical, problem-solving, written communication, and stakeholder coordination skills.

Responsibilities

• Analyze provider rosters and network data to identify gaps in specialty coverage, geographic access, appointment capacity, and credentialing status.
• 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 provider enrollment and credentialing workflows, metrics, delays, and compliance concerns and recommend improvements.
• Support provider recruitment, communications, training, and credentialing prioritization activities.
• Provide consultative support for network-related escalations and help identify qualified providers for member care needs.
• Develop or update SOPs, process maps, training materials, templates, and other knowledge-management resources.

Skills

Analytical skills

Data analysis

Dashboard development

Stakeholder coordination

Written communication

Tools

MS Office

Teams

SharePoint

Job description

Provider Network Support

Location: US-Remote

Planned Systems International is seeking a Provider Network Support Specialist to help strengthen provider network access, capacity, enrollment, credentialing, compliance, and operational performance for a federal healthcare program. This role will analyze provider network data, identify coverage and capacity gaps, support provider enrollment and recruitment activities, assist with network-related case escalations, and develop reports and recommendations for program leadership. The ideal candidate is analytical, collaborative, detail-oriented, and comfortable coordinating with clinical, operational, and contractor stakeholders.

On July 1, 2011, Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), WTC Health Program was established as a federal health care program to provide medical monitoring and treatment for eligible members in accordance with the James Zadroga 9/11 Health and Compensation Act of 2010. On December 18, 2015, President Obama signed the James Zadroga 9/11 Health and Compensation Reauthorization Act which reauthorized the WTC Health Program for 75 years, ending in 2090.

Essential Functions and Job Responsibilities

• Analyze provider rosters and network data to identify gaps in specialty coverage, geographic access, appointment capacity, and credentialing status.
• 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 provider enrollment and credentialing workflows, metrics, delays, and compliance concerns and recommend practical improvements.
• Support provider recruitment, communications, training, and credentialing prioritization activities.
• Provide consultative support for network-related escalations and help identify qualified providers for member care needs.
• Support single case agreements and letters of agreement through established review and approval processes.
• Conduct quality reviews and audits of provider files and network processes, document findings, and track corrective actions.
• Develop or update SOPs, process maps, training materials, templates, and other knowledge-management resources.
• Participate in program meetings, document decisions and action items, and coordinate follow-up with responsible stakeholders.
• Safeguard member, provider, and program information in accordance with applicable privacy, security, and records‑management requirements.

Minimum Requirements

• Experience supporting provider network operations, provider enrollment, credentialing, healthcare operations, managed care, or a related function.
• Demonstrated ability to analyze operational data, identify gaps or trends, and translate findings into actionable recommendations.
• Experience developing dashboards, reports, process documentation, or briefing materials.
• Strong organizational, analytical, problem‑solving, written communication, and stakeholder‑coordination skills.
• Ability to manage recurring deliverables, maintain accurate documentation, and track issues through resolution.
• Ability to handle sensitive healthcare and provider information appropriately.

Additional Information

• MS Office (Word, Excel, Powerpoint, Outlook)
• Communication tools (Teams, SharePoint)

Company Benefits

• Competitive total compensation package that includes paid leave
• employer sponsored group medical
• dental
• vision
• short-term disability
• long-term disability
• life insurance
• AD&D coverage
• legal services
• identity theft
• accident insurance
• Flexible spending account
• health saving account options offer pre‑tax savings for qualified medical, dental, and vision expenses
• company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested
• professional growth of employees through professional courses, certifications, and tuition reimbursement programs

EEO Commitment

It is company policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits, and termination, are made without regard to race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, citizenship status, veteran status, protected veteran status, disability, or any other characteristic protected by applicable federal, state, or local law.