Senior Provider Operations Specialist

Job Summary

Working remotely on a full-time basis, the Senior Provider Operations Specialist will manage data pipelines, execute enrollment updates, and maintain reconciliation workflows across multiple payer networks while ensuring operational documentation is accurate and accessible.

Key responsibilities

• Validate data pipelines and execute bulk enrollment record updates
• Build and maintain operational documentation and standard operating procedures (SOPs) for enrollment and roster management
• Scope operational requirements for new initiatives to ensure readiness and accurate implementation

Required qualifications

• 3+ years of experience in healthcare operations, data management, or provider network operations
• Proven ability to analyze operational data and troubleshoot discrepancies using spreadsheets
• Experience manipulating and validating large datasets for accuracy and completeness
• Ability to manage competing priorities and communicate effectively with stakeholders
• Strong written and verbal communication skills for summarizing operational data for diverse audiences