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Role Description

Help shape smarter, more effective provider networks that expand access, ensure compliance, and support the long-term success of our markets. As a Network Operations Advisor, you play a critical role in designing and sustaining alternative access networks—partnering across the enterprise to translate strategy into execution with precision and care.

• Serve as the subject matter expert for alternative access products in assigned markets, including inclusion and exclusion criteria, anchor providers, and network adequacy standards.
• Evaluate network design options and provide clear, data-driven recommendations that balance access, compliance, and market needs.
• Lead end-to-end coordination of network builds, reconfigurations, and expansions by translating contracting intent into actionable direction for Network Solutions and Network Operations.
• Ensure delivery system criteria are interpreted and applied consistently across tools, processes, and products.
• Partner with Compliance to support regulatory submissions, filings, and ongoing adherence to state and federal requirements.
• Monitor network adequacy, quality, and performance through ongoing analysis, identifying risks and recommending corrective actions.
• Manage implementation milestones and timelines, proactively addressing dependencies and maintenance needs.
• Support post-implementation activities including LocalPlus TrueUps, market sign-offs, and ongoing network integrity efforts.
• Collaborate with regional and national partners to resolve complex issues, support escalations, and ensure continuity of care.
• Contribute to training, documentation, and continuous improvement efforts; provide guidance to other Network Operations Advisors as needed.

Qualifications

• Required: 5+ years of experience in managed healthcare or a related field.
• Required: 3+ years of experience in provider contracting, provider services, network management, product, or compliance.
• Required: Demonstrated knowledge of provider networks, network adequacy, and healthcare professional data structures.
• Required: Strong analytical, critical thinking, and problem-solving skills.
• Required: Ability to work effectively in a fast-paced, matrixed environment and influence across teams.
• Required: Proficiency with Excel and data analysis tools.
• Preferred: Bachelor’s degree or equivalent professional experience.
• Preferred: Experience supporting commercial and/or government healthcare products.
• Preferred: Familiarity with regulatory requirements related to network adequacy and provider access.
• Preferred: Experience with provider contracting systems and data mining.
• Preferred: Strong project management and stakeholder communication skills.

Requirements

• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Benefits

• Annual salary of 79,700 - 132,800 USD / yearly, depending on relevant factors, including experience and geographic location.
• Eligibility to participate in an annual bonus plan.
• Comprehensive range of benefits, with a focus on supporting your whole health.
• Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment.
• 401(k), company paid life insurance, tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.