Remote Provider Network Manager II (Contracts & Relations)

BlueCross BlueShield of Tennessee, Inc.; Chattanooga (TN); Remote; USD 85,000 - 110,000; Full time

Job summary

BlueCross BlueShield of Tennessee, Inc. seeks a Network Manager to strengthen our provider networks across Tennessee.

You will partner with physicians, hospitals, and ancillary providers, assisting with contract negotiations, resolving complex issues, and analyzing reimbursement impacts to improve provider experience and network performance. The ideal candidate has provider contracting/health insurance experience, strong analytical and negotiation skills, and a passion for building productive

Qualifications

• Bachelor's degree or equivalent work experience in business/healthcare.
• 3 years in provider relations and network development with focus on healthcare education and reimbursement.
• Public speaking and effective presentation skills.
• Ability to work independently with minimal supervision and in teams.
• Translate technical concepts into business language for project teams.

Responsibilities

• Identify educational topics and strategies to enhance provider network compliance.
• Support and monitor provider programs and enterprise initiatives.
• Maintain regulatory and contract compliance improvements.
• Handle escalated provider enrollment processing and problem resolution.
• Lead data reporting and analysis to monitor financial and service relations with providers.
• Consult with providers on delivery, training and support issues.
• Travel to provider offices or conduct virtual meetings as required.

Skills

Public speaking

Independent work

Translate complex concepts

MS Office

Analytical skills

Time management

Oral communication

Written communication

Interpersonal skills

Organizational skills

Multi-project handling

Proactive attitude

Real-world healthcare terminology

Contract language knowledge

Education

Bachelor's degree in business or healthcare or relevant field or equivalent work experience

Tools

Microsoft Office

Job description

BlueCross BlueShield of Tennessee, Inc. seeks a Network Manager to strengthen our provider networks across Tennessee.

You will partner with physicians, hospitals, and ancillary providers, assisting with contract negotiations, resolving complex issues, and analyzing reimbursement impacts to improve provider experience and network performance. The ideal candidate has provider contracting/health insurance experience, strong analytical and negotiation skills, and a passion for building productive