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Remote Provider Network Development Jobs in Georgia

Aledade

Field Marketing Manager (Remote)

Atlanta, GA · Remote

... providers. * Partner Cross-functionally with Network Development Leadership to Develop Strategic ... remote-first culture - you've come to the right place. What Does This Mean for You? At Aledade, you ...

AutomationDirect

Network Administrator

Cumming, GA · Remote

Maintain the current environment and provide daily network support for the company * Review ... remote access, network segmentation, access control, and secure connectivity between internal ...

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Remote Provider Network Development information

What are some common challenges faced by professionals in remote provider network development roles and how can they be addressed?

One of the main challenges in Remote Provider Network Development is building strong relationships with providers and stakeholders without regular face-to-face interaction. This requires effective virtual communication skills and the ability to leverage digital collaboration tools. Additionally, navigating differing regulations and provider expectations across regions can be complex, so staying organized and informed about local requirements is crucial. Proactively scheduling regular check-ins and utilizing centralized documentation can help maintain alignment and foster trust among network partners.

What is the difference between Remote Provider Network Development vs Remote Provider Relations Specialist?

AspectRemote Provider Network DevelopmentRemote Provider Relations Specialist
Primary FocusBuilding and expanding provider networks, negotiating contractsManaging existing provider relationships, resolving issues
Required CredentialsHealthcare administration, insurance, or related certificationsCustomer service, healthcare administration certifications
Work EnvironmentStrategic planning, cross-department collaborationProvider communication, issue resolution
Industry UsageHealth insurance companies, managed care organizations

Remote Provider Network Development focuses on expanding and negotiating provider networks, while Remote Provider Relations Specialists manage ongoing provider relationships and address issues. Both roles require healthcare or insurance knowledge but differ in their strategic versus operational focus.

What is a remote provider network development specialist?

A Remote Provider Network Development specialist is responsible for identifying, recruiting, and managing healthcare providers to join a health plan’s network, all while working remotely. They negotiate contracts, ensure providers meet quality standards, and maintain strong relationships to ensure network adequacy. This role often involves analyzing data to identify network gaps and collaborating with internal teams to address member needs. Remote work allows these specialists to connect with providers across various regions without needing to be on-site.

What are the key skills and qualifications needed to thrive as a remote provider network development professional, and why are they important?

To excel in Remote Provider Network Development, you need expertise in healthcare network management, contract negotiation, and provider relations, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with health plan software, CRM tools, and knowledge of regulatory compliance systems are typically required. Strong communication, relationship-building, and problem-solving skills are essential for establishing and maintaining provider partnerships. These skills ensure effective network expansion, regulatory compliance, and high-quality service for health plan members.
What are the most commonly searched types of Provider Network Development jobs in Georgia? The most popular types of Provider Network Development jobs in Georgia are:
What are popular job titles related to Remote Provider Network Development jobs in Georgia? For Remote Provider Network Development jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Development jobs in Georgia look for? The top searched job categories for Remote Provider Network Development jobs in Georgia are:
What cities in Georgia are hiring for Remote Provider Network Development jobs? Cities in Georgia with the most Remote Provider Network Development job openings:
Remote Provider Network Development jobs near you

Manager, Network Contracting (Georgia)

Oscar Health

Atlanta, GA • Remote

$100K - $132K/yr

Other

Medical, PTO

Posted 14 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

251st of 301 rated insurance

Job description

We're hiring a Manager to join our Network Contracting Team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family.

About the role:

The Manager, Network Contracting & Services is responsible for managing a team of individuals who support specific healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Manager also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost- saving initiatives; executing the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care.

You will report into the Senior Director, Network Contracting & Services.

Work Location: This is a remote position based in the field, open to candidates who reside Alabama, Florida, Georgia, South Carolina. Your daily work will involve a blend of work from your home office and frequent local travel for client meetings. Occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is $100,602 - $132,040 per year You are also eligible for employee benefits, unlimited PTO, and annual performance bonuses.

Responsibilities:

  • Implement contracting strategies under the direction of Network Lead and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
  • Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
  • Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
  • Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
  • Monitor team performance for defined metrics and SLAs including but not limited to provider outreach and contract completion.
  • Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
  • Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies.

Requirements:

  • 6+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management
  • 4+ years of experience managing complex Provider Network strategies and negotiating complex contracts
  • 3+ years experience in Health Insurance (Individual and/or ACA Market Place) and/or Healthcare industry

Bonus points:

  • Bachelor's degree or equivalent professional working experience.
  • 3+ years of leadership experience

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