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Provider Network Manager

Green Key Resources Meridian ,ID
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

We are actively seeking a Provider Network Manager to join our Health Plan team in Meridian, ID! 

RESPONSIBILITIES for Provider Network Manager:

  • Responsible for the management of complex contract arrangements and negotiations for value-based reimbursements with hospitals and other multiplex providers.
  • Monitor and audit the financial performance of assigned contracts.
  • Build and communication channels with internal business partners.
  • Develop networks and identify areas of opportunity for greater efficiency and risk mitigation.
  • Ensure the accurate implementation and administration of executed contracts.
  • Assist in the resolution of escalated and/or complex provider complaints and problems. 
  • Provide guidance or expertise to less experienced team members as needed.

Qualifications for Provider Network Manager:

  • Seven years contracting and negotiation experience involving complex delivery systems
  • Intimate understanding and experience with hospital, managed care and provider business models.
  • Bachelor’s degree or equivalent work experience (Two years work experience is equivalent to one year of college)
  • Knowledge of: 

    • Complex reimbursement methodologies

    • Value-based arrangement methodologies and performance measurement

    • CMS regulatory requirements and reimbursement methodology

    • Systems and methods used in performing data and financial analysis

    • The general organization and operations of hospitals, physician offices and other providers

    • Health plan operations including claims process and medical management controls and processes

    • Methods to monitor provider performance 

    • Technical, legal or contract writing 

Hours for Provider Network Manager:

  • Monday - Friday 8am - 5:30pm

Advantages of this Opportunity:

· Salary is based on experience, tenure, certifications etc. (very competitive with market place)

Next Steps:

If you’re interested in speaking in more detail, please apply today! We are scheduling interviews ASAP.

Company Description
Premier executive recruitment firm specializing in permanent placement, contract consulting, temp-to-hire and temporary staffing within the following specialty areas: accounting-finance, healthcare nursing & allied health, pharmaceutical, financial service operations, information technology, creative, hospitality, office/legal support and human resources across our offices nationwide.

Our recruiters are highly-specialized consultants who only recruit within specific job disciplines. Each of our division leaders has over a decade of direct experience working in the industries they serve. The bottom line is that we understand your business, your challenges – and most importantly what it takes to source and successfully hire top talent. When you’re looking to hire people who make an immediate impact, unlock your potential with Green Key Resources.

Green Key Resources

Premier executive recruitment firm specializing in permanent placement, contract consulting, temp-to-hire and temporary staffing within the following specialty areas: accounting-finance, healthcare nursing & allied health, pharmaceutical, financial service operations, information technology, creative, hospitality, office/legal support and human resources across our offices nationwide. Our recruiters are highly-specialized consultants who only recruit within specific job disciplines. Each of our division leaders has over a decade of direct experience working in the industries they serve. The bottom line is that we understand your business, your challenges – and most importantly what it takes to source and successfully hire top talent. When you’re looking to hire people who make an immediate impact, unlock your potential with Green Key Resources.

Address

Meridian, ID
83642 USA

Website