About this role
About the Role We are currently seeking a highly motivated Provider Network Operations Representative to support our Texas Market Provider Network Operations team. This role reports to the Sr. Manager, Provider Network Operations and is responsible for supporting the day-to-day operational activities of the provider network, including provider onboarding, maintenance, issue resolution, and compliance-related processes. The ideal candidate is detail-oriented, customer-focused, and highly organized, with a passion for supporting providers and improving operational efficiency. This individual will serve as a key liaison between providers and internal departments, helping ensure accurate provider data, timely issue resolution, and compliance with regulatory and health plan requirements. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team Support provider network operations, including provider onboarding, terminations, demographic updates, and maintenance of provider records. Coordinate provider-related activities across Contracting, Credentialing, Claims, Provider Relations, and other internal teams. Serve as a primary point of contact for provider operational inquiries, network status questions, and administrative support needs. Investigate, track, and resolve provider issues related to claims, reimbursement, EDI rejections, network participation, and operational processes. Maintain accurate provider records, documentation, tracking logs, and operational workflows. Assist with provider directory validation, audits, regulatory reporting, and data accuracy initiatives. Compile and distribute operational reports related to provider network activities and performance. Collaborate with internal departments and field-based network teams to support provider onboarding, education, and operational readiness. Participate in process improvement initiatives designed to enhance provider experience, operational efficiency, and data quality. Support health plan, regulatory, and organizational compliance requirements, including audit preparation and readiness activities.