North Carolina Provider Network Specialist

Job Summary

A company is looking for a Provider Network Specialist-Disputes to manage provider disputes and ensure a high-quality network for members.

Key Responsibilities

• Oversees the provider dispute resolution process and maintains dispute logs
• Conducts contract compliance monitoring and interprets audit results to improve service quality
• Acts as a subject matter expert on provider issues and manages contract terminations

Required Qualifications

• Bachelor's Degree in mental health, public health, social work, psychology, education, sociology, business, or public administration
• Two years of experience in health-related fields, social work, or education, with a focus on network operations and provider relations
• Master's Degree with clinical licensure preferred