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Entry Level Provider Network Development Jobs in Alabama

VIVA Health

Credentialing Coordinator

Birmingham, AL

This position will act as a resource for provider data integrity, provider file management and network development. Key Responsibilities * Receive, interpret and incorporate Council for Affordable ...

Viva Health

Credentialing Coordinator

Birmingham, AL · On-site

This position will act as a resource for provider data integrity, provider file management and network development. Key Responsibilities * Receive, interpret and incorporate Council for Affordable ...

i3

Network Administrator

Huntsville, AL · On-site

Provides network performance statistics, reports and recommendations for network enhancements ... game development and implementation. We have established a broad offering of products and ...

i3

Mid-Level Network Administrator

Huntsville, AL · On-site

Provides network performance statistics, reports and recommendations for network enhancements ... game development and implementation. We have established a broad offering of products and ...

Global Star Marketing

Be Seen First

Entry Level Marketing and Sales Assistant

Birmingham, AL · On-site

$67K - $73K/yr

... development . No previous marketing or sales experience is required. We provide paid training ... Opportunities for networking, travel, company events, and team activities * Full-time schedule ...

Peraton

Network Administrator

Redstone Arsenal, AL · On-site

$51K - $82K/yr

Assists in development of custom software or hardware network components. * Provides ongoing maintenance and support of hardware and software network components and applications. * Provides user and ...

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Entry Level Provider Network Development information

What is an Entry Level Provider Network Development role?

An Entry Level Provider Network Development role involves assisting in building and maintaining relationships between healthcare providers and health insurance companies. Professionals in this position help with tasks such as recruiting new providers, ensuring contract compliance, and gathering necessary documentation. They support the network team by performing data entry, preparing reports, and communicating with providers to resolve any issues. This role serves as a foundation for understanding the healthcare network process and often provides opportunities for career growth within the industry.

What are some common challenges faced by entry level professionals in provider network development, and how can they overcome them?

Entry level professionals in provider network development often face challenges such as building relationships with healthcare providers, navigating complex insurance regulations, and quickly learning industry terminology. To overcome these hurdles, it helps to proactively seek mentorship from experienced colleagues, attend trainings or workshops, and regularly review internal documentation and industry guidelines. Strong communication skills and a willingness to ask questions can also make it easier to collaborate with team members and external partners, leading to greater confidence and success in the role.

What are the key skills and qualifications needed to thrive as an Entry Level Provider Network Development professional, and why are they important?

To thrive as an Entry Level Provider Network Development professional, you need a basic understanding of healthcare systems, strong analytical skills, and a bachelor's degree in healthcare administration, business, or a related field. Familiarity with provider management software, claims processing systems, and proficiency in Microsoft Excel are commonly required technical competencies. Strong interpersonal communication, negotiation skills, and attention to detail help you build relationships with providers and manage contracts effectively. These skills are crucial for ensuring robust provider networks, supporting organizational goals, and maintaining compliance with regulatory requirements.

What is the difference between Entry Level Provider Network Development vs Entry Level Provider Relations Coordinator?

AspectEntry Level Provider Network DevelopmentEntry Level Provider Relations Coordinator
CredentialsTypically requires a bachelor's degree in healthcare, business, or related fieldSimilar educational background, often with healthcare or business focus
Work EnvironmentFocuses on building and managing provider networks, analyzing data, and strategic planningCenters on maintaining provider relationships, communication, and resolving provider issues
Employer & Industry UsageUsed in health insurance companies, managed care organizations, and healthcare networksCommon in insurance companies, healthcare providers, and provider organizations

While both roles involve healthcare provider interactions, Entry Level Provider Network Development emphasizes network expansion and strategic planning, whereas Entry Level Provider Relations Coordinator focuses on maintaining provider relationships and communication. Both roles require similar educational backgrounds and are vital in healthcare organizations, but they differ in daily responsibilities and focus areas.

What are the most commonly searched types of Provider Network Development jobs in Alabama? The most popular types of Provider Network Development jobs in Alabama are:
What cities in Alabama are hiring for Entry Level Provider Network Development jobs? Cities in Alabama with the most Entry Level Provider Network Development job openings:
Entry Level Provider Network Development jobs near you

Credentialing Coordinator

Triton Health Systems

Birmingham, AL

Full-time

Posted 11 days ago

Job description

Credentialing Coordinator

Location: Birmingham, AL

Work Schedule: Hybrid - after a 5-6 month training period that will be completed 100% onsite at our downtown Birmingham office, this position can transition to a hybrid work schedule with a mix of in-office and remote work. The successful candidate must reside within a reasonable travel distance of Birmingham.

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

  • Comprehensive Health, Vision, and Dental Coverage
  • 401(k) Savings Plan with company match and immediate vesting
  • Paid Time Off (PTO)
  • 9 Paid Holidays annually plus a Floating Holiday to use as you choose
  • Tuition Assistance
  • Flexible Spending Accounts
  • Healthcare Reimbursement Account
  • Paid Parental Leave
  • Community Service Time Off
  • Life Insurance and Disability Coverage
  • Employee Wellness Program
  • Training and Development Programs to develop new skills and reach career goals
  • Employee Assistance Program

See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits

Job Description

The Credentialing Coordinator is responsible for credentialing and re-credentialing practitioners, ancillary service providers and allied health professionals to ensure their qualification to participate in VIVA HEALTH’S provider network. The Credentialing Coordinator will serve a primary role in receiving and incorporating provider data appropriately into the provider set-up workflow process. This position will act as a resource for provider data integrity, provider file management and network development.

Key Responsibilities

  • Receive, interpret and incorporate Council for Affordable Quality Healthcare (CAQH) provider data into the credentialing, re-credentialing, and provider data auditing process.
  • Use CAQH data and credentialing software findings to make credentialing decisions regarding providers.
  • Analyze trends in monthly credentialing data to forecast workload for CAQH.
  • Communicate with internal departments to ensure quality assurance findings related to providers are reviewed and acted upon accordingly.

REQUIRED QUALIFICATIONS:

  • Bachelor's Degree or equivalent experience in credentialing
  • 3 years of experience in credentialing
  • Ability to analyze and solve problems related to credentialing of providers and facilities
  • Proficient in manipulation of data to report statistical information to several of departments
  • Ability to work independently, research and resolve processing issues in a timely manner with little to no supervision
  • Organized, detail oriented, and skilled at multi-tasking
  • Demonstrate excellent customer service skills through written and verbal communication
  • Proficient in the Microsoft Office suite of products
  • Knowledge of credentialing software, CAQH, CMS, NCQA guidelines, and JCAHO regulations