This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

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.
• Demonstrated knowledge of provider networks, network adequacy, and healthcare professional data structures.
• Strong analytical, critical thinking, and problem-solving skills.
• Ability to work effectively in a fast-paced, matrixed environment and influence across teams.
• 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

• Anticipated annual salary of 79,700 - 132,800 USD / yearly, depending on relevant factors, including experience and geographic location.
• Eligible 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.