Provider Network Specialist

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Analyze provider demographic information, financial data, quality reports, and special project data. • Support the performance team in preparing for and executing monthly provider performance meetings. • Conduct in-depth audits across provider performance systems, including Orinoco, online search tools, print directories, Looker reports, and claims payment processes. • Evaluate data through a performance lens to identify gaps, inefficiencies, and root causes impacting provider performance. • Deliver clear, actionable insights and partner with the performance team to implement improvements that enhance overall provider effectiveness. • Engage directly with providers to resolve provider-related issues and ensure timely resolution and clear documentation. • Manage the full contract lifecycle while maintaining a focus on onboarding high-performing providers and improving overall engagement. • Partner with Performance Managers to prepare for monthly performance meetings by pulling data and preparing slide decks and follow-up items.

🎯 Requirements

• A minimum of 3 years of healthcare experience, preferably in Medicare Advantage or similar environments • 5 years of direct provider interaction experience • Demonstrated ability to manage detailed, performance-driven work • Proficiency in Google or MS Suite Workspace applications. • Experience in claims research, provider setup, root cause analysis, and process improvement with a focus on provider engagement • Strong written and oral communication skills.

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles • Parental leave program • 401K program • And more....