Provider and Health Plan Operations Specialist
About the role The Provider and Health Plan Operations Specialist supports provider credentialing, payer contracting, and operational execution across multiple states and health plans. You'll complete credentialing applications with commercial carriers, maintain payer relationships, support providers through the enrollment process, and ensure seamless operational execution. This role reports to the Senior Vice President of Provider and Health Plan Operations. Our ideal Candidate (will be happy to): • Complete credentialing applications and gather required documentation (licenses, certifications, malpractice insurance, NPIs, tax documents) • Track application status, follow up with payers, and maintain organized credentialing files • Serve as a point of contact for providers on credentialing and enrollment matters • Navigate payer-specific systems and portals including CAQH ProView and Availity • Build relationships with payer representatives and document all communications • Support quality assurance initiatives and maintain compliance documentation The Basics: • Strong attention to detail and accuracy • Excellent time management and ability to prioritize competing deadlines • Professional communication skills with internal and external stakeholders • Process-oriented with strong organizational skills • Comfort navigating multiple systems and platforms • Collaborative team player Bonus Points for: • Experience with provider credentialing or payer enrollment • Familiarity with CAQH ProView, Availity, or similar credentialing platforms • Healthcare operations or health plan experience • Knowledge of state licensing requirements and payer policies Apply tot his job