What are the responsibilities and job description for the Provider Network Manager (Remote - Must Live in Miami) position at Premier Physician Support Services?
Job Description – Provider Network Manager (Miami-Dade County)
Reports to: SVP, Contracting and Network
FLSA Status: Exempt
Position Summary
The Provider Network Manager oversees, expands, and optimizes Nuvia Medical’s provider network within Miami-Dade County. The role supports contract growth, network adequacy, provider performance improvement, and successful onboarding of new affiliates across Medicaid, Medicare Advantage, and Exchange lines of business. This position builds strong provider relationships, interprets market dynamics, and ensures operational readiness and performance standards across the territory.
Primary Responsibilities
Network Oversight & Performance
- • Monitor provider and clinic performance, including quality outcomes, utilization trends, compliance, patient access, and membership growth.
- • Conduct recurring provider business reviews and deliver actionable recommendations.
- • Identify and resolve operational or service-related issues impacting outcomes or patient experience.
Network Growth & Development
- • Execute strategic plans to expand the Miami-Dade provider network.
- • Source, evaluate, and negotiate agreements with Primary Care providers and clinic partners.
- • Lead onboarding and integration processes to ensure timely credentialing, enrollment, and activation.
Credentialing & Enrollment
- • Coordinate provider credentialing and enrollment workflows to support activation across Medicaid, Medicare Advantage, and Exchange payors.
- • Maintain accurate provider data across internal systems, payer portals, rosters, and directories.
Market Intelligence & Relationship Management
- • Maintain a deep understanding of competitive landscape, regional healthcare needs, and market trends.
- • Build and sustain strong relationships with provider partners, office managers, administrators, and health plan representatives.
- • Represent Nuvia at provider engagement events, community outreach activities, and payer discussions.
Performance Reporting & Territory Insights
- • Deliver monthly performance dashboards, territory summaries, and operational reports.
- • Identify risks, barriers, and opportunities; develop mitigation strategies and present findings to leadership.
- • Support cross-functional initiatives that advance network performance and market expansion.
Qualifications
Education & Certification
• Bachelor’s degree in Healthcare Administration, Business, or related field preferred; equivalent work experience will be considered.
Experience
- • 3 years of provider network management, practice management, healthcare contracting, or MSO operations experience.
- • Experience with Medicaid, Medicare Advantage, and Exchange payor programs required.
- • Experience with credentialing, enrollment workflows, and payer portals strongly preferred.
Skills & Knowledge
- • Strong negotiation, communication, and relationship-building abilities.
- • Knowledge of regulatory requirements, payer structures, and network adequacy standards.
- • Analytical and data interpretation skills; proficiency in Microsoft Office and related systems.
- • Bilingual (English/Spanish) strongly preferred due to market needs.
Core Competencies
- • Strategic territory development
- • Contracting & negotiation
- • Credentialing & enrollment coordination
- • Analytical reasoning & data interpretation
- • Provider relationship management
- • Problem solving & operational improvement
- • Cross-functional collaboration
Core Values & Behaviors
Integrity
Acts honestly, ethically, and builds trust with providers, colleagues, and partners. Maintains confidentiality and consistently upholds organizational and regulatory standards.
Compassion
Engages with providers and teams with empathy, professionalism, and understanding. Supports a relationship-centered approach across the network.
Accountability
Takes responsibility for work quality, timelines, and performance outcomes across assigned territory. Follows through on commitments and resolves issues promptly.
Respect
Treats all providers, staff, and stakeholders with professionalism and dignity, fostering a collaborative and inclusive environment.
Excellence
Strives for continuous improvement in network performance, operational processes, and provider engagement. Promotes innovation and high-quality service delivery.
Work Environment / Physical Demands
This position requires frequent driving, standing, walking, and interaction with clinical and administrative teams. Regular use of computers and communication tools is required. May occasionally lift or move items up to 25 lbs.
Travel Requirements
This position requires regular travel throughout Miami-Dade County (up to 50–60%).
Schedule / Hours
This is a full-time position, Monday through Friday, with occasional evenings or weekends based on provider needs or organizational priorities.
Equal Employment Opportunity Statement
We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
Salary Range (50th Percentile Philosophy – Florida)
Minimum: $90,000
Midpoint: $100,000
Maximum: $110,000
This range aligns with Florida market benchmarks and Nuvia Medical’s compensation philosophy of paying at the market median.
Salary : $90,000 - $110,000