Network Engineer

Overview

Remote
Depends on Experience
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 12 Month(s)
No Travel Required

Skills

Healthcare
Network Engineer
AI automation
CAQH
NPPES
NCQA
CMS
Software Design
Data Flow
Health Care
Network
Onboarding
Regulatory Compliance
Artificial Intelligence
Communication
Customer Relationship Management (CRM)
Data Domain
Usability
Workflow

Job Details

Job ID: FL-DMS-2425-313-1

Remote/Local Healthcare (must) Network Engineer (15+) with AI automation, CAQH/NPPES/NCQA/CMS experience

Location: Tallahassee, FL (DOH)
Duration: 12 Months

JD 1: Healthcare Provider Data Domain Expert (Non-Technical)
Purpose:
Bring real-world understanding of how provider data flows from providers to payers. Help the tech team avoid bad assumptions and define what s practical when designing AI and dual-system workflows.
Key Responsibilities:
Explain how provider data typically flows from:
o Individual providers, group practices, CAQH, NPPES to payers.
Outline how payers (like Healthfirst) process and validate this data.
Define real-world provider lifecycle events:
o Onboarding, re-credentialing, terminations, address/specialty updates.
Identify common operational pain points:
o Duplicates, outdated credentials, slow syncs, mismatches across systems.
Help assess what AI can realistically automate vs. where human judgment is required.
Validate assumptions in the solution design and flag compliance or usability concerns.

Must-Have Skills:
working in provider data operations or credentialing at a health plan, MSO, or vendor.
Deep knowledge of CAQH workflows, NPPES, NCQA/CMS directory requirements.
Familiarity with how provider data is consumed downstream (CRM, Claims, Portals).
Strong communication skills to advise engineers clearly on edge cases and operational reality.

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