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Provider Relations Network Specialist 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 Relations Manager Jobs
By DynamiCare Health At Pittsburgh, PA, United States
Prepare and maintain up-to-date enrollment workflows consistent with requirements of specific implementations.
Pull and distribute monthly reporting per requirements of individual provider contracts.
An active Counseling License (OMSAS) or Substance Use Disorder Certification (Pennsylvania Certification Board) is strongly preferred.
Previous experience (2+ years) working in the SUD (addictions) profession
Knowledge of substance use disorders; if in recovery, at least 2 years of sustained recovery
Excellent oral and written communication skills, organizational skills, and high attention to detail
Developer Relations, Pl Network
By Protocol Labs At , Remote
Extremely strong interpersonal, written, and verbal communication skills.
Experience writing documentation or producing other content to synthesize and simplify technical concepts for technical and non-technical audiences
Experience with developer relations and developer support
Experience teaching, writing, or hosting workshops
Experience working with distributed systems (cyber security, cloud computing, networks, etc.)
Experience working in or managing open source software communities
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.
Provider Relations Specialist Jobs
By Mom's Meals At Ankeny, IA, United States
Assist in continual training to assigned providers on best practices and other resources to assist with claims, authorizations, member benefits, etc.
Strong communication skills and ability to use appropriate tact and finesse when dealing with delicate issues
Strong organizational skills to coordinate new partnerships and keep processes moving
Ability to think outside the box and offer new suggestions for integrating new procedures
Experience working in a healthcare, provider or HMO/PPO environment familiar with billing claims and authorization processes
Position Responsibilities may include, but not limited to
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.
Assoc Specialist, Provider Network Admin - Remote
By Molina Healthcare INC At United States
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Min. 1 year managed care experience
2+ years managed care experience
Associate's Degree or equivalent combination of education and experience
Reviews/analyzes data by applying job knowledge to ensure appropriate information has been provided.
Experience in one of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
Provider Relations Manager Jobs
By CareMax, Inc. At Brockton, MA, United States
Proactive, analytical relationship management expert
Strong organizational and planning skills to manage multiple priorities and meet required deadlines
Access to continual education through CareMax University
Experience working with VBCs (value based contracts)
Minimum of three (3)– years of provider network operational experience
Strong analytical, critical thinking and problem solving skills to ensure process improvement and projects are completed successfully
Provider Relations Specialist Jobs
By Insight Global At Springfield, Massachusetts Metropolitan Area, United States
Detailed orientated problem solver with excellent time management skills and ability to meet filing due dates
Associates Degree in Health Administration, Business Administration, Regulatory Science or an equivalent combination of education and work experience in related field.
Two to three years of experience working in health insurance and regulatory industry
Strong writing, communication and interpersonal skills
Health insurance industry experience preferred
Participate in oversight calls with PPO Networks and vendors to coordinate regulatory compliance and document meeting minutes that meet regulatory guidance.
Provider Relations Associate Jobs
By CareMax, Inc. At Orlando, FL, United States
Proactive, analytical relationship management expert
Strong organizational and planning skills to manage multiple priorities and meet required deadlines
Access to continual education through CareMax University
Experience working with VBCs (value based contracts)
Minimum of three (3) – years of provider network operational experience
Strong analytical, critical thinking and problem solving skills to ensure process improvement and projects are completed successfully
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.
Network Relations Coordinator Jobs
By Meritage Medical Network At Petaluma, CA, United States

Network Relations Coordinator Location: Petaluma, CA Employment Status: Full-Time, Hybrid Hourly Range: $21.83/hr. - $25.87/hr.; DOE Summary: As a key member of the Network 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.

Director, Network Management (Provider Relations) (Director Ii)
By CalOptima At Orange, CA, United States
Bachelor’s degree in Health Care Management or a related field required.
5 years of progressive leadership experience, including direct supervision of staff, in managed care, providers or health plans required.
Medicaid managed care, Medicare risk-contract, or commercial Health Maintenance Organization (HMO) insurance experience required.
Master’s degree in Health Care Management or related field.
Medi-Cal managed care plan experience or related government client or public sector experience.
Directs training of providers to promote cost-effective managed care, compliance, and enhancement of service standards.
Provider Relations Specialist Jobs
By Mindlance At United States
100% Remote/ Work from Home
·The main purpose of this role is to reschedule all canceled appointments either by patient are provider.
·Strategize, coordinate, create and execute Provider schedules efficiently and effectively.
·The Candidate must be comfortable making 200+ outbound calls a day and working in an independent environment.
·Reschedule all appointments canceled either by patient are provider.
·Establish concierge level relationships with assigned providers.
Provider Relations Manager Jobs
By Connect Chiropractic At Wauwatosa, WI, United States
Requirements For a Provider Relations Manager
Experience in marketing, sales, or networking
OUR IDEAL PROVIDER RELATIONS MANAGER
Public Speaking Abilities Are Preferred.
Customer service driven - Eager to help customers find solutions regardless of challenges
Respectful - Treats others with kindness and is positive and helpful
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 Relations Specialist (Remote-New York)
By Maximus At United States
3+ years of Health Plan Provider Relations, Recruiting and Vendor Management experience required.
Responsible for appropriate documentation of recruitment and relationship management activities in tracking system
Assist with monthly and quarterly reporting to Management/Credentialing/Operations Support Unit
Performs other duties as may be assigned by Management.
Bachelor's degree in related field, or equivalent combination of education and experience.
This is a fully remote position located in the state of New York.
Provider Relations Manager- Remote
By Prime Therapeutics At , Remote $59,610 - $95,370 a year
Bachelor's degree in a related field, or at least 4 additional years of experience in healthcare, network development, network management.
5-8 years experience in a Provider Relations role for a managed care plan.
Takes the front-line in establishing and maintaining strong communications with providers. Collaborates with Regional Managers and manages staff and support activities.
Solid knowledge of health plan operations required.
Assists with network strategy committee meeting and network application processing decision committees
Collaborates and monitors with credentialing teams to ensure provider compliance with provider and state contracts.