Provider Network Manager

American Health Partners

. Execute agreements with healthcare providers and essential vendors in assigned markets to establish competitive and cost-effective healthcare provider networks that meet CMS network adequacy standards .

Posted 9/15/2026full-timeRemote • Tennessee • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managed care and network development, with a strong focus on maintaining network adequacy and compliance with CMS standards. Proven ability to build relationships with healthcare providers and vendors while effectively communicating program benefits and goals.

Highest-signal resume keywords

Managed Care ExperienceNetwork DevelopmentNegotiation SkillsHealthcare Provider CredentialingMedicare Advantage Knowledge

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Network Adequacy AnalysisHealthcare Provider AgreementsCompliance TrainingMicrosoft Office SuiteTime Management

Soft Skills

Strong CommunicationTeam CollaborationOrganizational SkillsSelf-MotivationDependability

Industry Keywords

Healthcare Provider NetworksCMS StandardsAcute FacilitiesPost-Acute FacilitiesVendor Management

About the role

Key responsibilities & impact

Execute agreements with healthcare providers and essential vendors in assigned markets to establish competitive and cost-effective healthcare provider networks that meet CMS network adequacy standards
Ensure providers and essential vendors meet credentialing requirements
Analyze the Health Plan(s) provider network to maintain network adequacy on an ongoing basis
Support implementation of Health Plan(s) in new markets as needed
Establish a positive work environment that encourages process improvement and commitment to department/company success
Complete corporate assignments, including compliance training, as assigned
Maintain positive business relationships with contracted providers
Report on material changes in assigned markets
Serve as a subject matter expert for other functional areas within the organization

Requirements

What you’ll need

Must have knowledge and familiarity with all levels of medical services and ability to rapidly develop working relationships
Must be able to accept instructions and work independently in the completions of goals and assignments
Must have strong negotiation, organization, presentation, and time management skills
Must be able to effectively communicate with medical staff to explain the Health Plan(s) program, benefits, and goals
Must be able to work effectively in a team environment
Excellent computer skills, including Microsoft Office Suite
Must be self-motivated, dependable, team and goal oriented
Successful completion of required training
Handle multiple priorities effectively
Independent discretion/decision making
Reliable transportation
Current automobile insurance according to company policy
Bachelor’s degree or equivalent work experience
Five (5) plus years of experience in managed care/network development/network services
Experience in the health care field required
Prior experience with Medicare Advantage plans is helpful
Prior experience in network development/network services is required
Prior experience with acute and post-acute facilities is beneficial
Must be available to work 8 a.m. until 5 p.m. local time
Position requires intermittent travel to network provider locations

Benefits

Comp & perks

Affordable Medical/Dental/Vision insurance options
Generous paid time-off program and paid holidays for full time staff
TeleDoc 24/7/365 access to doctors
Optional short- and long-term disability plans
Employee Assistance Plan (EAP)
401K retirement accounts with company match
Employee Referral Bonus Program
Teleworking is an option if criteria is met