Network Management Implementation Specialist

Role Responsibilities:

• Manage end-to-end provider onboarding and offboarding, including project coordination for audits, data loading, configuration, and reporting.
• Develop workflows and maintain documentation to ensure data integrity and operational readiness throughout the provider lifecycle.
• Collaborate with cross-functional teams like Credentialing, Provider Relations, and IT to ensure compliance and process efficiency.

Key Activities:

• Monitor project milestones and risks, facilitating timely resolutions to maintain accuracy and efficiency in provider implementation.
• Serve as a liaison in governance committees, providing expertise on provider implementation and operational optimization.
• Facilitate provider communications and education, enhancing materials and conducting presentations to ensure clarity on requirements.

Strategic Contributions:

• Drive continuous process improvement by identifying enhancements to tools, templates, and reporting that increase provider satisfaction.
• Support system modernization efforts by capturing business requirements, testing enhancements, and validating system changes.
• Ensure regulatory and audit readiness by adhering to CMS and NCQA requirements through accurate documentation and lifecycle tracking.