Job Details

A company is looking for a Provider Network Specialist-Disputes to manage provider disputes and ensure a high-quality network for members.Key ResponsibilitiesOversees the provider dispute resolution process and maintains dispute logsConducts contract compliance monitoring and interprets audit results to improve service qualityActs as a subject matter expert on provider issues and manages contract terminationsRequired QualificationsBachelor's Degree in mental health, public health, social work, psychology, education, sociology, business, or public administrationTwo years of experience in health-related fields, social work, or education, with a focus on network operations and provider relationsMaster's Degree with clinical licensure preferred