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# IPA, Network Provider Specialist [DALLAS]

- **Company:** NUTEX HEALTH HOLDCO LLC
- **Location:** Austin, TX, United States
- **Experience:** Experienced
- **Contract:** Permanent contract
- **Skills:** Microsoft Word, Microsoft Excel, Data Analysis, Databases, Healthcare Effectiveness Data and Information Set, Microsoft Office, Network Administration, Microsoft PowerPoint
- **Published:** October 5, 2026
- **Apply:** https://www.indeed.com/viewjob?jk=ed899bf11b5e116e

## About the Role

* Knowledge of MS Office: Word, Excel, PowerPoint, Access Database.
 * Knowledge of MS Provider relations/customer service strategies.
 * Knowledge of MSO-VL and MMSE programs and services: Authorizations, Claims, Credentialing encounters, RAF, Star Ratings, IS/IR, etc.
 * Knowledge of Network development strategies and Provider Relations experience or similar background.
 * Knowledge of current MSO-VL and MMSE geo-access requirements.
 * Effective and efficient oral and written communication skills.
 * Knowledge of County provider demographics.
 * Skills in negotiating contract language and rate structures.
 * Skills to provide training and technical assistance to contracted providers.
 * Skills to evaluate and assess provider network to determine gaps and services needed.
 * Skills to identify and develop new providers to ensure accessibility.
 * Skills to monitor contract performance through site visits and data analysis.
 * Skills to facilitate contracted provider meetings.
 * Ability to represent the department or division professionally.
 * Ability to establish and maintain effective working relationships with contracted and potential providers.
 * Ability to resolve provider inquiries or requests promptly., * Bachelor's Degree in Marketing or Business Administration
 * Minimum of 2 years experience in Network Management within a managed care environment, health plan, or significant medical group administration.

## Description

* Completes new provider orientation for all applicable product lines.
 * Conducts provider group meetings to review monthly/quarterly data and outcomes.
 * Responsible for meeting minutes and follow-up on 'TO DO' items identified at meetings.
 * Conduct site visits to service providers, resolve issues, educate staff and providers on policies, and collect credentialing information.
 * Conduct site visits to service providers and educate staff and providers on submitting Risk Adjustment Factor Data and HEDIS information.
 * Maintains relationships with contracted HMOs to implement amendments to DOFR, delegation, policy, and procedures.
 * Returns all routine calls from providers within 24 hours to establish consistent and robust relationships with provider offices.
 * Provide oversight on inquiries and claims issues and follow up with providers to ensure problems have been resolved.
 * Maintains provider office tools, including provider manual.
 * Supports regional Network Improvement Plan targets by providing utilization reports, ER contingencies, Frequent Flier Reports, and other analytics available to improve /maintain regions.
 * Identifies network gaps and completes contracts for PCP, Specialist, and Ancillary networks with in-depth knowledge of different fee schedules (Medicare/Medical/ASP/AWP).
 * Identifies new cost-saving possibilities through working with various committees, such as UM and Claims.
 * Understands and explains risk contracts (shared risk/entire risk).
 * Strategizes for membership growth and retention.
 * Provide training, mentoring, and guidance to new representatives.
 * Works on special projects as assigned or directed.