Provider Network Specialist

Job Description MUST BE LOCATED IN WASHINGTON or OREGON A bit about the role…. This highly impactful role will analyze provider demographic information, financial data, quality reports, and special project data. A key responsibility is supporting the performance team in preparing for and executing monthly provider performance meetings, ensuring insights are actionable and aligned with performance goals. The ideal candidate brings a strong understanding of data analysis , claims payment processes, provider setup, and root cause analysis, with a clear focus on improving provider engagement. Success in this role requires the ability to work both independently and collaboratively, strong organizational discipline, and a results-driven mindset. Key Responsibilities and Impact Provider Performance Audits Conduct in-depth audits across provider performance systems, including Orinoco (demographics and fee schedules), 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. Field Performance Support and Issue Resolution Support Field Performance initiatives by engaging directly with providers to resolve provider-related issues. Ensure timely resolution and clear documentation. ​Provider Onboard