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The Network Development Specialist supports the provider enrollment process and plays a vital role in the operational success of Managed Care and Business Development initiatives. This role focuses on maintaining payor compliance through audit coordination, managing provider enrollment activities, and assisting in partner-facing initiatives that drive network growth and efficiency. The Specialist collaborates cross-functionally to ensure timely and accurate provider onboarding and supports strategic projects aligned with organizational goals.
Reports To: Manager, Network Development
Responsibilities:
• Coordinate the enrollment of healthcare providers with payors by preparing and submitting applications and required documentation in a timely manner.
• Maintain secure and accurate records of provider enrollment information; ensure ongoing documentation integrity throughout the enrollment lifecycle.
• Serve as the point of contact for audit-related requests; receive, prepare, and submit payor audits in compliance with applicable contractual and regulatory standards.
• Collaborate with internal departments including Managed Care, Business Development, and Provider Relations to support outreach, onboarding, and operational efforts.
• Provide administrative and operational support for business development functions, including tracking partner interactions, preparing materials, and assisting with outreach coordination.
• Communicate effectively with internal stakeholders and external partners (e.g., payors, brokers, community businesses) to resolve enrollment issues and support relationship management.
• Assist with data integrity and reporting using credentialing, enrollment, or contract management systems; ensure accurate and up-to-date provider network information.
• Stay informed of industry regulations, payor requirements, and enrollment process changes that may impact provider onboarding and network operations.
Education and Experience
• Bachelor’s in healthcare administration, business, or a related field preferred
• Prior experience in provider enrollment, managed care, or healthcare administration required
• Experience with payor processes, compliance audits, or business development support is a plus
Licensures/Certifications
• Certification in provider enrollment or credentialing (e.g., CPCS) is desirable but not required
• Familiarity with healthcare compliance, payor systems, and provider onboarding preferred
Skills and Abilities
• Highly organized with strong attention to detail
• Excellent written and verbal communication skills
• Proficiency in Microsoft Office and healthcare data systems
• Ability to prioritize tasks, timelines, and adapt in a dynamic, cross-functional environment
• Collaborative mindset with a proactive approach to problem-solving and follow-through
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*