Field Network Provider Specialist

Nutex Holdco LLC; Houston (TX); On-site; USD 65,000 - 95,000; Full time

Job summary

Nutex Holdco LLC seeks a Provider Network Specialist to manage and expand the physician network across our regions. You will travel to provider offices, educate staff on policies, and gather credentialing information to support product lines.

Responsibilities include conducting meetings, generating outcomes data, and maintaining HMOs relationships for contract amendments. Strong MS Office skills and patient-centric provider relations experience are essential.

Qualifications

• Bachelor’s degree in Marketing or Business Administration required.
• Knowledgeable in MS Office (Word, Excel, PowerPoint, Access).
• Experience in network management within managed care or medical groups preferred.
• Strong communication and negotiation abilities.

Responsibilities

• Completes new provider orientation for applicable product lines.
• Conducts provider group meetings to review data and outcomes.
• Responsible for meeting minutes and follow-up actions identified in meetings.
• Conducts site visits to service providers and educates staff on policies.
• Educates providers on submitting Risk Adjustment Factor Data and HEDIS information.
• Maintains relationships with contracted HMOs to implement amendments.
• Responds to provider inquiries and resolves issues, within 24 hours when possible.
• Provides utilization reports and analytics to support network improvement plans.
• Identifies network gaps and contracts new PCP/Specialist/Ancillary providers.

Skills

MS Office

Provider relations

Customer service strategies

Data analysis

Communication skills

Education

Bachelor's Degree in Marketing or Business Administration

Job description

Nutex Holdco LLC seeks a Provider Network Specialist to manage and expand the physician network across our regions. You will travel to provider offices, educate staff on policies, and gather credentialing information to support product lines.

Responsibilities include conducting meetings, generating outcomes data, and maintaining HMOs relationships for contract amendments. Strong MS Office skills and patient-centric provider relations experience are essential.