Network Management Specialist

Magellan Health

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

Posted 10/15/2026full-timeRemote • United StatesJunior💰 $45,655 - $68,485 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in network management and provider relations, ensuring compliance with NCQA requirements and maintaining high standards of network quality. Proficient in conducting audits, provider education, and administrative activities to support organizational goals.

Highest-signal resume keywords

Network ManagementProvider RelationsNCQA ComplianceMicrosoft ExcelPresentation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Network Composition AnalysisContracting InitiativesIssue ResolutionProvider EducationAudit Management

Soft Skills

Independent WorkPrioritizationCommunication

Tools & Technologies

Microsoft Office SuitePowerPoint

Industry Keywords

CredentialingQuality-of-CareProvider ComplianceLegal RequirementsRegulatory Compliance

About the role

Key responsibilities & impact

Support activities related to developing and maintaining physician, practitioner, group, facility, MPPS, and organization services 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
Provide issue resolution and complex troubleshooting for providers
Conduct provider education and provider relations activities
Conduct administrative provider site visits and coordinate report development and completion
Coordinate PPRC activities to maintain credentialing status and address quality-of-care issues and provider complaints
Manage ongoing audits of provider compliance with Magellan policies, procedures, and contractual obligations
Develop work plans to address audit requirements
Work with management to draft, clarify, and recommend policy changes impacting network management
Perform additional duties aligned with the intent of the role as assigned

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 a related position/field
Required education: GED or high school
Must comply with applicable legal, regulatory, contractual, and internal policy requirements
Must understand, comply with, and attest to position-specific security responsibilities and controls

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