Provider Network Management Jobs
Provider Network Management jobs are open across health insurance, managed care, hospitals, and health systems, from coordinator to director level, with specializations in contracting, credentialing, and network development. Find a role that fits from the openings below and apply directly.
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Showing 5 of 18+ Provider Network Management jobs
Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237
Compensation Pay Range:
Minimum Offer $53,768.00 Maximum Offer $82,076.80
Now Hiring: Provider Network Management Relations Executive
Summary
Build your Career. Make a Difference. Presbyterian is hiring a skilled Provider Network Management Relations Executive to join our team.
Type of Opportunity: Full time
Job Exempt: Yes
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Days (United States of America)
Responsibilities:
Presbyterian Healthcare is seeking a Provider Network Management Relations Executive.
Provides oversight of network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian's clinical quality initiatives. Will provide the framework for physician/provider performance reporting that will assist providers with objective and quantitative analysis of clinical quality performance measures. The Network Relations Service Executive is a professional accountable for proactively identifying issues, resolving disputes, and coordinating resolutions. Accountable for resolving complex problems, fielding general questions, and acting as a liaison between the provider of service and the health plan.
Some key responsibilities include:
- Collaborates and maintains relationships with providers and staff throughout Presbyterian to ensure an exceptional provider experience.
- Develops and maintains cooperative working relationships between PHP, institutional provider and individual providers.
- Provides education on quality initiatives, managed care, capitation, products, policies and procedures, reimbursement issues, referral/authorization process, etc.
- Responsible for ensuring provider data integrity and accuracy by ensuring PIFs are completed timely and accurately and through a comprehensive review and validation of provider directory data.
- Responsible for post payment validation of assigned providers to ensure accuracy of payment to the contract and corresponding fee schedules.
- Resolves provider issues - claims, health services, finance, etc.
- Stimulates and fosters professional development of the Network Relations Service Associates.
- Supports Network Contracting strategies in an effort to preserve a robust provider network.
- Serves as primary liaison between the provider and the health plan.
- Maintains a general knowledge of health plan reimbursement methodologies.
- Conducts provider visits based on established departmental goals, which will require 50-65% field contact.
- Engages and supports leadership and peers by promoting and participating in department initiatives and being accountable for achieving business objectives.
Qualifications
- Three years experience in provider relations, provider contracting, claims processing, or customer service in a healthcare organization. Strong working knowledge of risk sharing programs and different reimbursement methodologies i.e. capitation, DRG, Relative Value Systems, etc. Must demonstrate strong verbal, written communication, and presentation skills with strong interpersonal and negotiations skills and ability to interface with providers. Must also possess strong facilitation, organizational, and personal computing skills.
Education:
Essential:
High School Diploma or GED
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinars, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237
Compensation Pay Range:
Minimum Offer $53,768.00 Maximum Offer $82,076.80
Now Hiring: Provider Network Management Relations Executive
Summary
Build your Career. Make a Difference. Presbyterian is hiring a skilled Provider Network Management Relations Executive to join our team.
Type of Opportunity: Full time
Job Exempt: Yes
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Days (United States of America)
Responsibilities:
Presbyterian Healthcare is seeking a Provider Network Management Relations Executive.
Provides oversight of network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian's clinical quality initiatives. Will provide the framework for physician/provider performance reporting that will assist providers with objective and quantitative analysis of clinical quality performance measures. The Network Relations Service Executive is a professional accountable for proactively identifying issues, resolving disputes, and coordinating resolutions. Accountable for resolving complex problems, fielding general questions, and acting as a liaison between the provider of service and the health plan.
Some key responsibilities include:
- Collaborates and maintains relationships with providers and staff throughout Presbyterian to ensure an exceptional provider experience.
- Develops and maintains cooperative working relationships between PHP, institutional provider and individual providers.
- Provides education on quality initiatives, managed care, capitation, products, policies and procedures, reimbursement issues, referral/authorization process, etc.
- Responsible for ensuring provider data integrity and accuracy by ensuring PIFs are completed timely and accurately and through a comprehensive review and validation of provider directory data.
- Responsible for post payment validation of assigned providers to ensure accuracy of payment to the contract and corresponding fee schedules.
- Resolves provider issues - claims, health services, finance, etc.
- Stimulates and fosters professional development of the Network Relations Service Associates.
- Supports Network Contracting strategies in an effort to preserve a robust provider network.
- Serves as primary liaison between the provider and the health plan.
- Maintains a general knowledge of health plan reimbursement methodologies.
- Conducts provider visits based on established departmental goals, which will require 50-65% field contact.
- Engages and supports leadership and peers by promoting and participating in department initiatives and being accountable for achieving business objectives.
Qualifications
- Three years experience in provider relations, provider contracting, claims processing, or customer service in a healthcare organization. Strong working knowledge of risk sharing programs and different reimbursement methodologies i.e. capitation, DRG, Relative Value Systems, etc. Must demonstrate strong verbal, written communication, and presentation skills with strong interpersonal and negotiations skills and ability to interface with providers. Must also possess strong facilitation, organizational, and personal computing skills.
Education:
Essential:
High School Diploma or GED
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinars, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
See All Provider Network Management Jobs
Jump back to the full list of openings and apply to any provider network management role that fits.
Find JobsProvider Network Management Job Market
A snapshot from current openings nationwide, updated as new roles post.
Who's Hiring
- Presbyterian Healthcare Services4
- Juniper Networks3
- UnitedHealthcare2
- AmeriHealth Caritas1
- Astrana Health1
Top Industries Hiring
- Healthcare & Medical Services10
- Insurance3
- Manufacturing3
- Consulting & Professional Services2
What Employers Look For
The qualifications that appear most often in provider network management jobs.
- 3-5 years of experience in provider contracting, credentialing, or network development
- Knowledge of fee schedule development, reimbursement methodologies, and value-based contract structures
- Proficiency with credentialing platforms such as CAQH ProView or equivalent systems
- Familiarity with network adequacy standards set by CMS, state regulators, or accreditation bodies
- Bachelor's degree in healthcare administration, business, or a related field
- Experience with provider data management systems and maintaining accurate provider directories
Tips for Your Provider Network Management Job Search
Tailor your resume to contract language
Hiring managers in provider network management look for fluency in fee schedules, value-based arrangements, and network adequacy standards. Name the specific contract types you've negotiated or reviewed rather than listing generic relationship management skills.
Apply early to roles that fit
Migrate Mate lists provider network management openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Highlight credentialing software you know
Employers routinely screen for hands-on experience with tools like CAQH ProView, Navicure, or similar credentialing platforms. If you've used any, call them out in your skills section by exact product name, not just 'credentialing software.'
Target openings by payer type strategically
Your background in commercial, Medicaid, or Medicare Advantage networks is not interchangeable to most employers. Search by payer segment and align your application materials to the regulatory and contracting nuances specific to that line of business.
Prepare case studies around network gaps
Interviewers frequently ask how you've addressed network adequacy deficiencies or recruited hard-to-fill specialties. Walk in with a specific example that covers how you identified the gap, your outreach approach, and the outcome in terms of access or compliance.
Negotiate using access compliance as leverage
When discussing offers, frame your value around regulatory risk reduction, not just headcount managed. Demonstrating you understand CMS or state network adequacy standards positions you as a strategic hire and supports a stronger compensation conversation.
Provider Network Management Jobs: Frequently Asked Questions
Which companies are hiring the most provider network managements?
The companies hiring the most provider network managements right now include Presbyterian Healthcare Services, Juniper Networks, and UnitedHealthcare, with the largest share of openings in New Mexico, California, and Georgia, based on current listings on Migrate Mate as of June 2026. Health plans, managed care organizations, and large hospital systems consistently represent the largest share of open roles.
How many provider network management jobs are remote?
About 39% of provider network management openings are fully remote or hybrid as of June 2026, reflecting the administrative nature of much of the work. Credentialing coordination and provider relations roles tend to be the most remote-friendly, while contracting positions that involve in-person provider negotiations are more likely to require on-site or travel-based work.
How do you become a provider network management?
Start with a bachelor's degree in healthcare administration, business, or a related field, then build foundational experience in healthcare operations, provider relations, or managed care. Develop fluency in provider contracting, credentialing workflows, and network adequacy requirements. Earning a credential such as the Certified Provider Credentialing Specialist designation strengthens your candidacy for mid-level and senior roles.
Can you get a provider network management job with little experience?
Entry-level roles exist in provider relations, credentialing coordination, and network operations support, and these are the most practical starting points with limited experience. Employers hiring at this level look for healthcare administration coursework, familiarity with insurance terminology, and demonstrated comfort working in compliance-driven environments. Internships or administrative roles at a health plan or hospital accelerate the path considerably.
What does the provider network management interview process look like?
Most processes run two to three rounds. An initial screening with a recruiter or HR contact focuses on your background in contracting or credentialing. A second interview with a network director or VP typically includes scenario-based questions about resolving network adequacy deficiencies, handling difficult provider negotiations, or managing a high-volume credentialing caseload. Some employers add a brief written exercise or case study at this stage.
Where can I find and apply to provider network management jobs?
You can find and apply to provider network management jobs on Migrate Mate, which lists current openings from across the United States in one place. Search for roles that match your background in contracting, credentialing, or network development, and apply directly to each listing that fits.
See All Provider Network Management Jobs
Jump back to the full list of openings and apply to any provider network management role that fits.
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