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Provider Network Analyst Iii Jobs

Analyst, Network & Provider Analytics
By Point32Health At , Remote
Under direct supervision, conduct detailed analyses that offer the Provider Performance Management team insights into cost drivers and best practices
Bachelors in Business Administration, Finance, Health Services required; Masters preferred
Strong oral, written and presentation skills
Key Responsibilities/Duties – what you will be doing
Qualifications – what you need to perform the job
Work under direct supervision to generate and enhance standard cost and utilization reports
Provider Research Analyst Jobs
By Sidecar Health At Ohio, United States
Strong organizational and time-management skills, with the ability to prioritize multiple tasks and meet tight deadlines.
Create comprehensive provider guides for your assigned service domain, including details on provider specialties, certifications, and pricing information
2+ years of experience in a similar role, preferably in the healthcare or insurance industry
Strong research and analytical skills, with the ability to quickly gather and analyze large amounts of data
Comprehensive Medical, Dental, and Vision benefits
Support members accessing affordable care for your assigned service domain by researching provider cash prices
Analyst, Provider Configuration - Network Adequacy/Sql - Remote
By Molina Healthcare At , Long Beach, 90802 $54,922 - $107,099 a year

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees:

Provider Network Specialist Jobs
By Premera Blue Cross At United States
Provide input on improvements regarding workflow, procedures, or policies and make recommendations to management.
Assure compliance with the National Committee for Quality Assurance (NCQA), Office of the Insurance Commissioner (OIC) and other regulatory agencies/requirements.
Three (3) years' experience in a production or customer service environment requiring attention to detailed procedures (Required).
One year of prior health care and provider information experience; medical office or billing experience.
Knowledge of other internal department operations or functions that assist in resolution of provider inquiries.
Experience in working with Microsoft Word and Excel.
Director Of Provider Network Development
By JLC Recruiting New York At United States
Thorough knowledge of laws and regulations relating to managed care and other payer functions.
This role is remote based (work from home) and will require approximately 35% travel throughout NY State
Administration (MHA); or equivalent education/experience such as bachelor’s degree in
a minimum of 10 years in leadership position-management of field-based teams
In partnership with National and local leadership, develop contracting growth strategies across all lines of the managed care portfolio.
Develop market level contracting strategies and alignment with finance and other operational areas of the organization.
Network Engineer Iii Jobs
By Milestone Technologies, Inc. At Phoenix, AZ, United States
Participates in ad hoc projects, client engagements, and tasks as requested by management
Document all aspects of Network infrastructure and maintain Knowledgebase and SOPs from which to address various issues/projects and requests
Experience configuring and troubleshooting routing and switching protocols (BGP, IS-IS, MPLS, RSVP-TE, VRRP)
Experience working in a multi-vendor environment with hands-on experience with networking hardware
Working knowledge of physical infrastructure design including structured cabling and fiber-optic cabling
Excellent judgement and analytical skills, ability to prioritize tasks based on fluctuating needs.
Provider Network Manager Jobs
By Elevance Health At United States
Contracts frequently involve non-standard arrangements that require a moderate level of negotiation skills.
Job Family: Digital and Technology
National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
Primary focus of this role is contracting and negotiating contract terms for value-based agreements.
Typically works with providers engaged in value-based arrangements and non-traditional provider types supporting SDOH initiatives and whole-health care delivery.
Deep understanding of Value based concepts understanding and innovative thoughts on health equity and whole-health.
Provider Network Executive Iii
By Premera Blue Cross At United States
Develop and execute ongoing account management and service strategy to meet corporate strategic/financial objectives.
Bachelor’s Degree or (4) years of experience in a provider or payer environment. (Required)
Knowledge of network development and provider/vendor network recruitment.
Knowledge of provider community and market anomalies.
Demonstrated ability to effectively manage complex contract negotiations.
Strong experience and expertise in Provider Relations.
Provider Network Account Specialist
By HonorHealth At Scottsdale, AZ, United States

network development or physician recruiting/sales

This is a Full-time position, but requires you to travel locally to meet with potential clients.

Medicare Network Account Provider Performance Analyst - Cigna Healthcare -Remote, Or
By Cigna Healthcare At Portland, OR, United States
Supporting the development, management and oversight of the physician/ provider network in his/her assigned territories
Developing time and cost effective territory management in compliance with department and enterprise goals.
Educating providers on the performance requirements associated with value-based contracts.
Direct experience with health plan operations, preferably specific to government sponsored health plans
Schedules, prepares for and participates in meetings with providers, provider staff, and/or physician leadership including creating and delivering presentations. 
Assisting in initiatives and performing special projects and other duties as assigned by leadership
National Provider Network Coordinator
By iCare Health Solutions At United States

Description The National Provider Network Coordinator will work closely with the Provider Recruiting and Contracting team(s) to organize recruitment efforts, providing analytical and administrative ...

Provider Network Reporting Analyst
By Medical Mutual of Ohio At ,
1-year experience in health insurance provider operations/data management which includes exposure to network reporting or similar analytics.
2 years’ experience as a Provider Network Reporting Analyst or equivalent experience in health insurance provider operations/data management.
5 years progressive experience as a Provider Network Reporting Analyst or equivalent experience in health insurance provider operations/data management.
Bachelor’s degree in Business Administration, Statistics or related field or equivalent combination of training/education and experience.
Acts as a resource for colleagues with less experience
Knowledge of provider data structure, including tax ID, demographics, etc.
Analyst Iii - Network Systems
By Klein Independent School District At , , Tx

Analyst III

Network Manager Provider Partnerships
By Blue Cross Blue Shield of Massachusetts At , Hingham, 02043, Ma $90,090 - $110,110 a year

***This position is eligible in the following personas:

Network Operations Analyst Iii
By Spectrum At , Greenwood Village, 80111, Co
Bachelor's Degree in Mathematics, Computer Science, Information Management or Statistics, Business Administration, or related field and / or equivalent work experience
Minimum five (5) years of experience project management tools, such as SmartSheet, Excel, SharePoint, and/or Confluence
Provide project management support for Network Operations: Generate high quality project communications that provide operational visibility to the business unit.
Facilitate communication between business unit and Network Operations from initial requirements to final implementation.
Actively and consistently support all efforts to simplify and enhance the customer experience.
Minimum five (5) years of experience using MS Office
Provider Network Data Analyst I
By AmeriHealth Caritas At , Raleigh, Nc
Management requirements are adhered to including language, terms and reimbursement requirements
Demonstrates a functional knowledge of provider data and managed care provider reimbursement methodologies.
Knowledge of Managed Care concepts
Responsible for the accuracy and timely management of the provider contracts
Bachelor’s Degree or equivalent education with work experience required.
Responsible for data intake process including knowledge of relevant systems required to complete job functions.
Provider Network Manager - Elevance Health
By Elevance Health At Albany, NY, United States
Experience in fee schedule development using actuarial models strongly preferred.
Experience with value-based contracting such as full risk models.
Job Family: Digital and Technology
National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
Works with increased independence and requires increased use of judgment and discretion.
May work on cross-functional projects requiring collaboration with other key areas.
Provider Network Analyst Iii
By Medica Services Company LLC At , Minnetonka, 55305, Mn
Time management skills and ability to meet deadlines
Bachelor's degree or equivalent experience in related field
5+ years of work experience in data analysis and reporting beyond degree
Advanced skills in Excel and Access required
Must possess strong decision making skills
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities