Network Management Specialist

Magellan Health

. Support activities related to developing and maintaining physician, practitioner, group, facility, MPPS and organization service delivery systems .

Posted 10/12/2026full-timeRemote • Texas • United StatesJunior💰 $45,655 - $68,485 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in network management, provider recruitment, and compliance with NCQA requirements, while effectively coordinating provider relations and conducting audits to ensure quality care and adherence to policies.

Highest-signal resume keywords

Network ManagementProvider RecruitmentNCQA RequirementsProvider RelationsAudit Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Network AnalysisContracting InitiativesProvider EducationAudit DevelopmentPolicy Recommendation

Soft Skills

Independent WorkPrioritizationPresentation Skills

Tools & Technologies

Microsoft Office SuiteExcelPowerPoint

Industry Keywords

Magellan PoliciesCredentialingQuality-of-CareComplianceSecurity Controls

About the role

Key responsibilities & impact

Support activities related to developing and maintaining physician, practitioner, group, facility, MPPS and organization service delivery systems
Interact with organizational areas to coordinate network management and administration responsibilities
Assess network needs and analyze network composition
Recruit providers to meet network adequacy standards and assure network quality
Conduct and coordinate contracting and amendment initiatives
Resolve complex provider issues and troubleshooting
Conduct provider education and provider relations activities
Conduct administrative provider site visits and coordinate report development
Coordinate PPRC activities related to credentialing status and quality-of-care issues and complaints
Manage ongoing audits of provider compliance with Magellan policies, procedures and contractual obligations
Develop work plans to address audit requirements
Draft, clarify and recommend policy changes affecting network management

Requirements

What you’ll need

Knowledge of National Committee for Quality Assurance (NCQA) requirements
Ability to work independently and prioritize activities
Intermediate knowledge of Microsoft Office Suite, specifically Excel
Strong presentation skills using PowerPoint
Minimum of 1 year experience in related position/field
GED or high school education required
Compliance with security responsibilities, security controls, legal, regulatory, contractual and internal policy requirements
Bachelor’s education preferred

Benefits

Comp & perks

Short-term incentives may be available
Comprehensive benefits package
Health, life, voluntary and other benefits
Benefits and perks supporting physical, mental, emotional and financial wellbeing
Tobacco-free workplace