Network Manager II

BlueCross BlueShield of Tennessee

. Identify educational topics, methods, and strategies to enhance compliance throughout the provider network .

Posted 10/9/2026full-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 provider relations and network development, with a strong focus on healthcare education, reimbursement methodologies, and regulatory compliance. Proficient in data analysis and reporting, with excellent communication and organizational skills to enhance provider networks and improve overall performance.

Highest-signal resume keywords

Provider Relations ExperienceHealthcare Education ExpertiseReimbursement Methodologies KnowledgeData Reporting and AnalysisContract Negotiation Skills

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

Provider Network DevelopmentRegulatory ComplianceData AnalysisMicrosoft Office ProficiencyMedical Terminology Knowledge

Soft Skills

Effective CommunicationInterpersonal SkillsOrganizational SkillsTime ManagementProblem Resolution

Certifications & Qualifications

Bachelor's Degree in Business or Healthcare

Industry Keywords

Managed Care Business ProcessesUtilization ManagementCase-Mix AdjustmentClaims Payment ApplicationsProvider Enrollment Processing

About the role

Key responsibilities & impact

Identify educational topics, methods, and strategies to enhance compliance throughout the provider network
Implement, support, and monitor provider programs and enterprise initiatives
Implement processes and changes to maintain regulatory and contract compliance and improve quality
Handle escalated provider enrollment processing and problem resolution
Lead data reporting and analysis projects monitoring financial and service relations with providers
Consult with providers on delivery, training, and support issues
Identify opportunities for enhancement and recommend solutions
Travel to provider offices or conduct virtual meetings as required
Support and strengthen provider networks across Tennessee
Assist with contract negotiations and resolve complex provider issues
Analyze reimbursement impacts and collaborate with internal teams to improve provider experience and network performance

Requirements

What you’ll need

Bachelor's degree in business, healthcare, or a relevant field, or equivalent work experience required
3 years of experience in provider relations and network development, emphasizing healthcare education and reimbursement
Ability to speak publicly and conduct effective presentations
Ability to work independently with minimal supervision or in a team environment
Ability to interpret and translate technical and complex concepts into meaningful information
Proficiency in Microsoft Office, including Outlook, Word, Excel, Access, and PowerPoint
Accuracy and attention to detail
Effective time management skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Strong analytical skills
Ability to manage multiple projects and priorities
Positive, self-driven, engaging, proactive, and results-driven attitude
Knowledge of medical terminology
Knowledge of contract language, reimbursement methodologies, managed care business processes, case-mix adjustment, utilization management, and applications for claims payment
Valid driver's license
Maintaining auto insurance compliance and an acceptable motor vehicle record when routinely driving for company business