Welcome page Returning Candidate? Log back in! Provider Network Manager Job Locations US-KY-LOUISVILLE ID 2026-182431 Line of Business Abilis Health Plan Position Type Full-Time Our Company

Abilis Health Plan

Overview

The Provider Network Manager is responsible for maintenance and management of an adequate provider network by fostering relationships with providers.

Responsibilities Identify and participate in process improvement initiatives that improve the customer experience, enhance workflow, and/or improve the work environmentMonitoring of various reports and collaborating with leadership to ensure all requirements are met and maintainedManagement duties including, but not limited to, hiring, training, and developing, coaching and counseling, and terminating department staff, as deemed necessaryReporting to leadership current status, risks, and potential opportunities in area of responsibilityMaintaining and analyzing network adequacy to quickly identity service gapsEnsures provider data base is accurate and up to dateOversees provider contracts by ensuring all credentialing documentation is received, documented, and stored per CMS requirementsEvaluates and monitors contract performance to determine necessity of amendments or extensions of contractsAnalyzes service agreements, financial reports, and other data to determine reasonableness of contractsCollaborating with Sales, Account Managers, and Credentialing to solve provider issuesParticipate in process improvement initiatives that improve the customer experience, enhance workflow, and/or improve the work environmentIdentifying contracting needs and collaborating with team to secure and negotiate needed contractsAssisting with negotiating and renegotiating contracts with physicians and provider groups as assignedResponsible for working and resolving provider disputes as necessary Qualifications Bachelor’s Degree in business or health related discipline such as Healthcare Administration or Healthcare ManagementTwo to three years Medicaid and/or Medicare experience preferredProvider servicing experienceKnowledge in provider data base managementExcellent verbal and written English communication skillsDemonstrated intermediate to advanced skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigationHighest level of professionalism with the ability to maintain confidentialityAbility to communicate at all levels of organization and work well within a team environment in support of company objectivesCustomer service oriented with the ability to work well under pressureStrong attention to detail and accuracy, excellent organization skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivityStrong analytical and problem-solving skillsAbility to take initiative and make suggestions for improvementsAbility to work with minimal supervision, take initiative and make independent decisionsAbility to deal with new tasks without the benefit of written proceduresApproachable flexible and adaptable to changeFunction independently, and have flexibility, personal integrity, and the ability to work effectively with stakeholders and vendors About our Line of Business Abilis Health Plan, an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare (Parts A and B) with prescription drug coverage (Part D). The Abilis Health Plan is a unique plan allowing members to enroll year-round. The plan focuses on members who meet residential requirements in participating nursing facilities. An interdisciplinary team of clinicians and innovative services allow us to meet each member’s clinical needs and provide preventive, coordinated, and quality healthcare. With a dedicated nurse practitioner leading a personalized care plan, we strive to improve the health of the communities in which we serve. For more information, please visit www.abilishealth.com. Follow us on LinkedIn.