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The Provider Relations Representative 1 is responsible for providing excellent customer service to providers, and providing timely and accurate responses to all provider concerns and issues.
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Possessing working experience in Payer or Provider operations (domain areas such as Medical Management, Population Health Management, Utilization Management, Provider Network Management, Value-Based Contracting, Provider Relations, Quality Improvement, Informatics, ACO operations, etc.
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Conduct ongoing staff development activities that advance negotiation skills, provider relations and network development processes. The Director of Network Management, Ancillary and Institutional Contracting, is responsible for assessing network needs, monitoring operational and fiscal performance and contractual compliance by network; along with coordination of recruitment/ provider negotiation needs with Medical Management, Network Operations, Hospital Contracting and Provider Relations.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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The Provider Network Manager develops the provider network through contract negotiations, relationship development, and servicing. Key responsibilities will include claims payment and remittance, network management, provider credentialing, data exchange and reporting and quality oversight.
$64,000 - $115,200 a yearFull-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Minimum of one (1) year of experience in provider network development and/or provider network management capacity, account management, or provider relations experience in a managed care organization required.
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Responsible for providing strategic leadership for provider engagement and contracting for assigned state with a benefit spend between $3 billion and $8 billion, including local cost of care and trend management, provider contracting, implementation, and local oversight of all types of payment innovation programs, and provider relations and education.
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7 years of experience in a healthcare or medical group management setting, including experience in provider network relations and business development required. In your role, you will have the opportunity to develop and oversee all aspects of the provider network strategy and lead the successful development of the provider network.
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The Network Relations Manager is responsible for the development and design of the provider network through contract negotiations and relationship development.
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4+ years in a Network/Provider Relations role. As a manager within our network contracting team, you'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting.
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The Provider Relations Representative will analyze assigned existing market needs, performs some standard contracting functions, educate providers and provider service entities, maintain business relationships for the Health Plan(s), report on provider and market changes, act as a support for other service areas for the Health Plan(s.
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This position reports to the SVP/GM, Provider Services – Navista Network. Collaborates with marketing and communications on the development and implementation of branding and marketing strategies to enhance the networks visibility & reputation through development of compelling messaging, promotional materials, and public relations initiatives.
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First (Days) (United States of America) Optima Health-VA beach is hiring a Network Relations Manager for their Network Department. Financial and operational performance of the provider network and compliance with contractual terms.
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Minimum 5 years in a progressive management position with a focus on program development, provider relations, marketing or in an Operations Specialist position. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company.
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Requires a BA/BS degree and a minimum of 8 years experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Work with provider relations team to develop and maintain a comprehensive provider network (hospitals, physicians, ancillary) that meets CMS access standards and deliver a full range of healthcare services to our members.
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provider relations network development jobs
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