Provider Network Performance Lead

CareMore Health Management Services, LLC; Tucson (AZ); Presencial; USD 81.000 - 122.000; Jornada completa

Descripción de la vacante

CareMore Health Management Services, LLC is seeking a Network Support Manager to optimize the provider network for access, quality, and value-based performance. You will oversee operational execution, resolve network issues, and engage providers to align with performance goals.

The role requires collaboration across multiple lines of business, contract administration experience, and knowledge of CMS programs.

Formación

• BA/BS degree required with minimum 3 years in health care provider relations, facility contracts, or reimbursement.
• MBA, MHA or related graduate degree strongly preferred.
• Experience with provider contracting language and operational requirements is essential.

Responsabilidades

• Oversee day-to-day training, guidance and management of department activities and facilitate resolution of problems.
• Analyze and coordinate strategies, policies and programs to ensure accurate administration of facility provider contracts.
• Create tools to assist contract implementation and administration.
• Interface with providers on contractual obligations, education, and provider operations manual updates.
• Coordinate projects to ensure accurate facility and provider reimbursement policy and procedures.

Conocimientos

Medicare Advantage

Value-based care

CMS programs

Claims analysis

Provider dashboards

EHR navigation

Provider contracting

Educación

BA/BS degree

MBA or MHA preferred

Descripción del empleo

CareMore Health Management Services, LLC is seeking a Network Support Manager to optimize the provider network for access, quality, and value-based performance. You will oversee operational execution, resolve network issues, and engage providers to align with performance goals.

The role requires collaboration across multiple lines of business, contract administration experience, and knowledge of CMS programs.