Remote Provider Network Operations Leader

Search Results; Southfield (MI); On-site; USD 70,000 - 90,000; Full time

Job summary

Search Results is seeking a Provider Network Operations Supervisor to oversee the daily operations of the Provider Network Operations team, ensuring quality performance and compliance with internal policies and contractual requirements.

The position is fully remote for Michigan-based candidates, with occasional attendance in Southfield, MI for monthly meetings. Strong leadership, healthcare operations knowledge, and ability to drive process improvements are essential.

Qualifications

• Associate degree required or equivalent combination of education and relevant work experience.
• 1 to 3 years of supervisory or leadership experience preferred.
• Experience in managed care or a healthcare environment preferred.
• Knowledge of claims processing, coding, payment, and/or provider data operations strongly preferred.
• Familiarity with Medicaid reimbursement methodologies preferred.

Responsibilities

• Supervise, coach, and monitor staff performance for quality and timely work.
• Support the Manager in implementing departmental initiatives and process improvements.
• Ensure processes align with policies, contracts, and SLAs.
• Oversee resolution of provider inquiries and complaints.
• Monitor provider data maintenance and claims-related activities.
• Research and resolve complex claims issues and discrepancies.
• Identify operational challenges and propose improvement solutions.
• Participate in special projects and additional duties as assigned.

Skills

Leadership

Healthcare operations

Analytical thinking

Multitasking

Communication

Process improvement

Education

Associate degree or equivalent

Job description

Search Results is seeking a Provider Network Operations Supervisor to oversee the daily operations of the Provider Network Operations team, ensuring quality performance and compliance with internal policies and contractual requirements.

The position is fully remote for Michigan-based candidates, with occasional attendance in Southfield, MI for monthly meetings. Strong leadership, healthcare operations knowledge, and ability to drive process improvements are essential.