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Medical Claims Eligibility Specialist - Billing & Collections

Houston, TX · On-site

$22/hr

Process billing for in-network and out-of-network medical claims . * Review and resubmit claims ... Ability to manage changing priorities in a fast-paced environment. * Proficiency with Microsoft ...

LA Health Solutions

Medical Assistant

Metairie, LA

$16 - $20.50/hr

Medical Assistant Monarch Medical Management Full-Time | Non-Exempt | Metairie, LA About Us Monarch Medical Management supports a network of specialty medical practices throughout the Greater New ...

LA Health Solutions

Medical Assistant

Metairie, LA · On-site

$16 - $20.50/hr

DESCRIPTION Medical Assistant Monarch Medical Management Full-Time | Non-Exempt | Metairie, LA About Us Monarch Medical Management supports a network of specialty medical practices throughout the ...

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Network Medical Management information

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$22K

$106.6K

$162.5K

How much do network medical management jobs pay per year?

As of Sep 2, 2026, the average yearly pay for network medical management in the United States is $106,570.00, according to ZipRecruiter salary data. Most workers in this role earn between $80,500.00 and $128,000.00 per year, depending on experience, location, and employer.

What is Network Medical Management?

Network Medical Management (NMM) refers to organizations or companies that provide administrative and management services to healthcare providers, such as independent physician associations (IPAs) and medical groups. NMM companies handle functions like claims processing, provider credentialing, contract negotiations, and care coordination to help streamline operations and improve patient care. Their goal is to support healthcare networks in delivering efficient, cost-effective, and high-quality services.

What are the key skills and qualifications needed to thrive as a Network Medical Management professional?

To excel in Network Medical Management, a strong background in healthcare administration, provider relations, and knowledge of managed care principles is essential, often supported by a degree in healthcare management or a related field. Familiarity with healthcare information systems, claims processing software, and regulatory compliance tools such as HIPAA and HEDIS is typically required. Excellent negotiation, problem-solving, and interpersonal communication skills help professionals build strong provider networks and resolve issues efficiently. These abilities are crucial for ensuring high-quality, cost-effective patient care and maintaining smooth operations in managed care organizations.

What are some of the typical daily challenges faced by professionals in Network Medical Management roles?

Professionals working in Network Medical Management often encounter challenges related to coordinating care among diverse providers, ensuring compliance with healthcare regulations, and optimizing provider network performance. A typical day may involve analyzing provider data, resolving credentialing issues, and addressing concerns from both providers and patients. Effective communication and strong organizational skills are essential, as the role frequently involves cross-functional collaboration with clinical staff, insurance companies, and IT teams to improve patient outcomes and ensure network efficiency.

What is the difference between Network Medical Management vs Medical Office Manager?

AspectNetwork Medical ManagementMedical Office Manager
CredentialsTypically requires healthcare administration or related certificationsOften requires medical office administration or related certifications
Work EnvironmentHealthcare networks, insurance companies, or large medical organizationsMedical clinics, outpatient offices, or small healthcare practices
Employer & Industry UsageUsed in healthcare management, insurance, and network organizationsCommon in individual medical practices and clinics
Primary FocusOverseeing network operations, provider relations, and complianceManaging daily office operations, staff, and patient scheduling

While both roles involve healthcare management, Network Medical Management focuses on overseeing healthcare networks and provider relations, often within larger organizations. In contrast, Medical Office Managers handle daily administrative tasks within individual medical practices. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

More about Network Medical Management jobs

What cities are hiring for Network Medical Management jobs?

Cities with the most Network Medical Management job openings:

What states have the most Network Medical Management jobs?

States with the most job openings for Network Medical Management jobs include:

What job categories do people searching Network Medical Management jobs look for?

The top searched job categories for Network Medical Management jobs are:

Network Medical Management jobs near you
Infographic showing various Network Medical Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $106,570 per year, or $51.2 per hour.

Supervisory Medical Management Specialist

SD Department of Veterans Affairs

Lexington, KY

$61K/yr

Full-time

Posted 7 days ago

Job description

This position is located within the Department of Veteran Affairs (VA), Veterans Health Administration (VHA), Veterans Integrated Service Network 9 (VISN9), at the Lexington Veterans Affairs Health Care System (LVAHCS). This position services as a Supervisory Medical Management Specialist for Specialty Care Service and reports directly to the Chief of Specialty Care Service.Qualifications:To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/02/2026.
Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-09 position you must have served 52 weeks at the GS-07. For a GS-11 position you must have served 52 weeks at the GS-09.The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade.
Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment.
You may qualify based on your experience and/or education as described below:
  • GS-9 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
  • Knowledge of an extensive body of rules, procedures, or operations that require extended training and experience to perform a wide variety of interrelated or non-standard procedural assignments and resolve a wide range of problems.
  • Skill in written and oral communications (to develop new procedures and effectively communicate changes to all levels of pharmacy personnel and coordinate changes between services).
  • Knowledge of overall VHA organization, types of facilities, organizational structure of VISN, medical center and services (to initiate appropriate actions for the service).
OR,
  • GS-9 Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related Ph.D. or equivalent doctoral degree.
OR,
  • GS-9 Experience/Education Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond graduate level education (in excess of the first two years or 36 semester hours) and specialized experience to meet total experience requirements.
GS-11 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
  • Knowledge of overall VHA organization, types of facilities, organizational structure of VISN, medical center and services (to initiate appropriate actions for the service).
  • Knowledge of hospital mission, management objectives, management principles and human resource management techniques (to supervise clerical staff, establish priorities and evaluate Specialty Care Service accomplishment of patient care objectives).
  • Knowledge of administrative issues pertaining to personnel management for bargaining unit and non-bargaining unit employees for appointments, disciplinary action, leave administration, workman's compensation, etc.
  • Skill in Microsoft programs including Excel, Word and Visio.
  • Knowledge of all operating clinical programs in which Specialty Care Service employees participate as well as ancillary services which interface with Specialty Care Service (to analyze programmatic progress compared to organizational objectives, and to identify and resolve problems between services).
  • Knowledge of labor relations processes, Medical Center and Specialty Care Service EEO goals and Merit Promotion Plans (to assure Specialty Care Service compliance in contract administration, affirmative action and other personnel programs).
  • Detailed knowledge of Medical Center and Specialty Care Service memoranda, guidelines and regulations which affect patient care programs and office operations processes of Specialty Care Service (to resolve problems which impede patient care delivery and to make procedural changes designated to improve the effectiveness of the service).
  • Skill in written and oral communications (to develop new procedures and effectively communicate changes to all levels of pharmacy personnel and coordinate changes between services).
  • Skill in applying analytical and evaluative methods and techniques to issues or functions related to office administration, knowledge of pertinent laws, regulations, policies and precedents which affect administrative operations;
  • Skills reviewing and analyzing current programs and procedures to identify areas of improvement.
  • Ability address unique challenges and situations that occur both within the normal tour of duty and outside the normal tour of duty.
  • Ability to oversight of daily activities and performance of subordinate staff, ensuring compliance with established policies and procedures and well as for conducting performance appraisals, providing feedback and professional development.
OR,
  • GS-11 Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed a Ph.D. or equivalent doctoral degree, or 3 full years of progressively higher-level graduate education leading to such a degree, or an LL.M. in a field related to this position. (Transcripts must be submitted with application)
OR,
  • GS-11 Experience/Education Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond graduate level education (in excess of the first two years or 36 semester hours) and specialized experience to meet total experience requirements.

You will be rated on the following Competencies for this position:
  • Accountability
  • Administration and Management
  • Communications
  • Cost Benefit Analysis
  • Customer Service
  • Decisiveness
  • Flexibility
  • Interpersonal Skills
  • Problem Solving
  • Resilience
  • Vision

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.
Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.
Physical Requirements: Work is primarily sedentary although some stooping, bending and carrying for retrieval of administrative materials and inventory equipment/supplies are required.
For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.Education:A transcript must be submitted with your application if you are basing all or part of your qualifications on education.
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.Employment Type: OTHER

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