Provider Network Operations Representative

Astrana Health

Provider network operations representative supporting Texas healthcare providers for Astrana Health. Managing onboarding, provider data, claims issues, compliance, and cross-functional operational workflows.

Posted 8/18/2026full-timeHouston • Texas • 🇺🇸 United StatesJuniorMid-Level💰 $47,000 - $60,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider network operations, including onboarding, claims resolution, and compliance with regulatory requirements. Proficient in maintaining accurate provider records and collaborating across departments to enhance operational efficiency and provider experience.

Highest-signal resume keywords

Provider Network OperationsClaims ResolutionProvider OnboardingRegulatory ComplianceProvider Data Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider RelationsHealthcare OperationsCredentialingContracting ProcessesClaims OperationsData Accuracy InitiativesOperational WorkflowsProcess ImprovementAudit PreparationNetwork Participation

Soft Skills

Organizational SkillsAttention to DetailCustomer ServiceCommunication SkillsRelationship-Building

Tools & Technologies

Microsoft Office SuiteProvider Management SystemsHealthcare PlatformsNetwork Databases

Industry Keywords

Healthcare AdministrationManaged CareHealth Plan AdministrationValue-Based CareCMSDMHC

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or a related field preferred
At least 2 years of experience in provider network operations, provider relations, healthcare operations, managed care, health plan administration, or a related healthcare environment
Experience supporting provider onboarding, provider maintenance, claims resolution, credentialing, or network operations
Strong organizational skills with exceptional attention to detail and accuracy
Excellent customer service, communication, and relationship-building skills
Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment
Proficiency with Microsoft Office Suite, including Word, Excel, Outlook, and Teams
Ability to work independently while collaborating effectively across multiple departments
Experience working with health plans, IPAs, ACOs, MSOs, or value-based care organizations preferred
Knowledge of provider data management, provider directories, claims operations, credentialing, and contracting processes preferred
Experience researching and resolving provider issues related to claims, reimbursement, and network participation preferred
Familiarity with CMS, DMHC, and regulatory requirements related to provider network operations preferred
Experience working with provider management systems, healthcare platforms, or network databases preferred

Benefits

Comp & perks

Hybrid work environment based on business needs
Frequent use of computers, healthcare systems, provider databases, and Microsoft Office applications
Ability to manage multiple projects, requests, and deadlines simultaneously
May require occasional travel for provider meetings, training sessions, or business-related events