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Remote Provider Network Management Jobs in Ohio (NOW HIRING)

$74K - $97K/yr

This position is for an IT Spec (Infosec/Network) , Position Description Number D2341000 , located ... provided a basic knowledge of data processing functions and general management principles that ...

$77K - $176K/yr

Remote Work: No Job Number: R0240810 Location: Wright Patterson AFB,OH,US Share job via: Share ... Knowledge of managing TACACS+ and RADIUS * Ability to create and manage network support ...

Network Engineer 3

Columbus, OH · On-site +1

$70K - $140K/yr

Provide Level 3/4 engineering support for the corporate enterprise network. * Verify hardware ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Network Engineer 3

Columbus, OH · On-site +1

$70K - $140K/yr

Provide Level 3/4 engineering support for the corporate enterprise network. * Verify hardware ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

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Remote Provider Network Management information

What are the key skills and qualifications needed to thrive as a Remote Provider Network Management professional, and why are they important?

To thrive in Remote Provider Network Management, you need expertise in healthcare provider relations, contract negotiation, and a solid understanding of health plan regulations, often supported by a degree in healthcare administration or a related field. Familiarity with provider network management software, data analytics tools, and knowledge of regulations like HIPAA are typically required. Excellent communication, problem-solving abilities, and attention to detail are essential soft skills for building strong partnerships and managing network performance. These skills and qualifications ensure efficient network operations, regulatory compliance, and high-quality service for both providers and members.

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

AspectRemote Provider Network ManagementRemote Provider Relations Specialist
CredentialsHealthcare administration, network management certificationsCustomer service, healthcare communication certifications
Work EnvironmentHealthcare organizations, insurance companies, remote office settingsHealthcare providers, insurance companies, remote customer support
Industry UsageManaging provider networks, credentialing, contractingBuilding provider relationships, resolving provider issues

Remote Provider Network Management focuses on overseeing healthcare provider networks, including credentialing and contracting. In contrast, Remote Provider Relations Specialists primarily handle communication and relationship-building with providers. Both roles require healthcare knowledge but differ in their core responsibilities and focus areas.

How does a Remote Provider Network Management professional typically collaborate with healthcare providers and internal teams?

Remote Provider Network Management professionals frequently coordinate with healthcare providers via virtual meetings, emails, and secure online portals to address contract negotiations, credentialing, and performance issues. They also work closely with internal departments such as claims, quality assurance, and customer service to ensure seamless provider onboarding and ongoing support. Effective communication and strong relationship-building skills are essential, as much of the collaboration happens through digital channels. This setup allows for flexibility but requires self-motivation and proactive engagement to maintain strong provider networks.

What is a Remote Provider Network Management role?

A Remote Provider Network Management role involves overseeing relationships and contracts with healthcare providers, such as doctors, hospitals, and clinics, while working remotely. Professionals in this field are responsible for recruiting new providers, maintaining communication, ensuring compliance with regulations, and addressing network issues. They play a key part in expanding and maintaining a healthcare organization's provider network to ensure members have access to quality care. This job typically requires strong organizational, negotiation, and communication skills, as well as familiarity with healthcare regulations and provider credentialing processes.
What are the most commonly searched types of Provider Network Management jobs in Ohio? The most popular types of Provider Network Management jobs in Ohio are:
What are popular job titles related to Remote Provider Network Management jobs in Ohio? For Remote Provider Network Management jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Management jobs in Ohio look for? The top searched job categories for Remote Provider Network Management jobs in Ohio are:
What cities in Ohio are hiring for Remote Provider Network Management jobs? Cities in Ohio with the most Remote Provider Network Management job openings:
Provider Relations Representative

Provider Relations Representative

Key Benefit Administrators

Columbus, OH • Remote

Full-time

Posted 27 days ago


Job description

Key Benefit Administrators is currently seeking a Provider Relations Representative to join the team. We are excited to speak to qualified candidates about opportunity. This position includes a comprehensive benefit package and competitive salary!

About Key Benefit Administrators

We are on a mission to improve health and stabilize insurance costs for local communities. KBA was founded in 1979 as a privately owned full-service group benefit administration firm specializing in self-funded medical plans and is now one of the country's largest independently owned third party administrators. We pride ourselves on having supportive leadership, a family atmosphere, and a high performing culture - ask our employees - they have agreed that we are a Top Workplace since 2013.

Check us out here:

Website | Glassdoor | Top Workplace

Position Summary:

The Provider Relations Representative will be responsible for the strategic direction, while maintaining successful oversight of all network relationships, network development, coordination, compliance, and contract functions of network management for the Key Family. 

Essential Duties and Responsibilities:

  • Relationship oversight of all current and potential networks.
  • Serves as a liaison between network relationships and network partners, Sales, Direct to Employer team and other operational teams within Key Family. 
  • Provide superior, professional, ongoing, consistent communication and service with designated networks and clients, to maintain a positive, long-term relationship. 
  • Maintain market intelligence on competitive landscape.
  • Detailed review, negotiation, editing and sign-off, in coordination with legal and VP, of all new and renewing network contracts.
  • Establishment and coordination of directly contracted hospital and/or provider systems within designated communities, creating formal direct to employer opportunities and/or informal partnerships. 
  • Oversee elevated network issues to resolution escalating to VP as necessary. 
  • Be available for occasional network/client related travel as needed.
  • Perform additional related duties as assigned. 

Does this sound like you?

  • 3+ years of network related experience in a healthcare or Third-Party Administrator (TPA) setting preferred.
  • Proven abilities in written and verbal communication, as well as presentation skills.
  • Highly proficient in Microsoft Office products, such as Microsoft Excel and Microsoft Word.
  • Ability to multi-task and work under deadlines.
  • Strong organizational, problem solving and analytical skills.
  • Highly experienced in relationship management with networks, clients and/or brokers.
  • Ability to work proficiently, independently, and timely in a fast-paced environment and be adaptable in a dynamic work environment.
  • People and team oriented.
  • Knowledge of conducting remote meetings using Zoom is a plus.
  • Detailed understanding of operational areas of health insurance is a plus.
  •  

If you are unable to complete an application for the Provider Relations Representative position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process.

All qualified applicants for the Provider Relations Representative position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender.

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