Network Management Jobs (NOW HIRING)

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com

Job Summary:

The Network Management Supervisor is responsible for overseeing and supervising provider network operations (credentialing and provider data management) and internal provider relations for all lines of business.  This position supervises the staff, workflows, accuracy, productivity and timeliness of the department as well as prepares reports for tracking and reporting purposes.   

Benefit Highlights:

• Loan Forgiveness Program 
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! · More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com  

Qualifications and Requirements:

• Minimum 3-5 years management experience in healthcare operations.
• Extensive experience required in claims billing and reimbursement knowledge for all nationally recognized billing forms, reimbursement methodologies for all provider types, member management, contract interpretation, fee implementation with third party administrators and insurance companies.
• Strong management and organizational skills to implement new products and services within these core network areas to assist in strategic development of existing and new products.
• Knowledge of credentialing process for Commercial and Medicare products.
• Knowledge of NCQA standards, project management, negotiating, analytical and problem solving skills.
• Ability to effectively communicate in English, both verbally and in writing.
• Proficient computer skills including MS Office (Word, Excel, Power Point, Publisher & Access), Outlook, SQL Analyzer, Adobe & FTP.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS

and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Qualifications and Requirements:

• Minimum 3-5 years management experience in healthcare operations.
• Extensive experience required in claims billing and reimbursement knowledge for all nationally recognized billing forms, reimbursement methodologies for all provider types, member management, contract interpretation, fee implementation with third party administrators and insurance companies.
• Strong management and organizational skills to implement new products and services within these core network areas to assist in strategic development of existing and new products.
• Knowledge of credentialing process for Commercial and Medicare products.
• Knowledge of NCQA standards, project management, negotiating, analytical and problem solving skills.
• Ability to effectively communicate in English, both verbally and in writing.
• Proficient computer skills including MS Office (Word, Excel, Power Point, Publisher & Access), Outlook, SQL Analyzer, Adobe & FTP.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS

and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.