Competitive Compensation & Benefits Package! Position eligible for –
- Annual incentive bonus plan
- Medical, dental, and vision insurance with low deductible/low cost health plan
- Generous vacation and sick time accrual
- 12 paid holidays
- State Retirement (pension plan)
- 401(k) Plan with employer match
- Company paid life and disability insurance
- Wellness Programs
- Public Service Loan Forgiveness Qualifying Employer
See attachment for additional details.
Location: Remote option; Available for any of Partners' NC locations
Projected Hiring Range: Depending on Experience
Closing Date: Open Until Filled
Primary Purpose of Position: Serve as a cross-functional liaison between Partners Health Management and a diverse network of Behavioral Health and Physical Health providers to support the development, stability, and performance of a high-quality provider network. This role strengthens provider partnerships through onboarding and offboarding coordination, education and training, targeted outreach, and the creation and maintenance of provider tools and resources. The Specialist also provides high-level administrative and operational support to the Provider Network Relations teams by triaging and resolving provider issues, supporting contract compliance activities, coordinating projects and communications, and promoting best practices that advance organizational goals and provider satisfaction.
Role and Responsibilities:
- Independently manage and maintain provider network documentation and records, ensuring accuracy, regulatory compliance, and protection of confidential information.
- Exercise judgment in the interpretation and application of policies, procedures, and regulatory requirements related to provider network administration.
- Serve as a key liaison between providers, Provider Network Relations leadership, and internal departments to assess issues, determine appropriate resolutions, and coordinate follow‑through.
- Coordinate and support provider‑focused initiatives, including onboarding, offboarding, education, training, and targeted outreach activities.
- Plan, organize, and facilitate provider meetings, trainings, and collaboratives, including agenda development, content coordination, documentation, and post‑session analysis.
- Develop and disseminate provider communications, outreach materials, and toolkits that support network engagement, compliance, and performance improvement.
- Utilize learning management and collaboration platforms to design, host, analyze, and report on training initiatives and provider participation outcomes.
- Analyze provider interaction data, performance indicators, and reporting requirements; identify trends, barriers, and improvement opportunities; and communicate findings to leadership.
- Provide consultative guidance and education to providers on foundational operational requirements, including claims and billing processes, authorization workflows, portal connectivity, and onboarding standards.
- Monitor emerging best practices, payer requirements, and regulatory changes affecting provider performance and network operations; proactively communicate implications and recommendations to departmental leadership.
- Conduct virtual and on‑site provider engagements to assess workflows, identify operational or performance gaps, and recommend targeted technical assistance or interventions.
- Collaborate with internal and external stakeholders to align resources, initiatives, and strategies that improve provider compliance, efficiency, and quality of care.
Knowledge, Skills and Abilities:
- Demonstrated strong ability to work in an electronic/computer-based setting with proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint) and Constant Contact
- Knowledge of the laws, regulations, and policies that govern the Health Plan.
- Excellent interpersonal skills
- Highly Skilled in written and oral communication skills
- Excellent time management and organizational skills
- Strong problem solving, negotiation, arbitration, and conflict resolution skills
- Considerable knowledge and expertise using learning management systems
- Knowledge of principles and methods for curriculum and training design, teaching, and instruction for adult learners and groups
- Knowledge of mental health, substance use disorder, and intellectual and developmental disability diagnoses and service delivery
- Ability to use presentation software, video conference and teleconference technology, and other training tools and technology
- Ability to exercise sound judgment in assessing training needs, developing objectives, recommending training goals, and evaluating training effectiveness
- Ability to collaborate in and contribute to brainstorming activities
- Ability to complete multiple tasks and manage a high volume of work within deadlines
- Ability to follow through on assigned tasks with limited supervision
- Ability to understand, interpret, write, and communicate complex information
- Ability to creatively solve problems using a solution-oriented, team-based approach
- Ability to retain composure and professionalism in high pressure conditions
- Strong attention to detail with the ability to edit and proofread internal and external documents
- Strong problem-solving, negotiation, and conflict resolution skills
- Knowledge of cultural diversity and the ability to create and maintain strong relationships with a wide range of consumers, families, providers, and stakeholders
- Experience with Electronic Health Records (EHR) for clinical processes
Education/Experience Required: Bachelor’s degree and a minimum of four (4) years of experience in managed care or a related field with a healthcare provider or insurer/payer. Relevant areas may include provider relations, network development or design, provider engagement services, contract management, or patient financial services. Experience in auditing, accounting, or finance is also applicable. A combination of relevant education and experience may be considered in lieu of a Bachelor’s degree.
Must be able to travel as required.
Must reside in North Carolina or within 40 miles of the NC border.
Education and Experience Preferred: Master’s degree in Public Health, Healthcare Administration, Nursing, or a related field.
Licensure/Certification Requirements: N/A
