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A leading healthcare provider seeks a Network Management Specialist to enhance provider database accuracy and engage in impactful healthcare delivery tasks. The role requires a Bachelor's degree and managed care expertise, offering opportunities for growth within a supportive environment focused on compliance and quality improvement.
Employer Industry: Managed Care
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package
- Work in a supportive environment focused on compliance and quality improvement
- Engage in critical provider network management tasks that impact healthcare delivery
- Chance to make a significant contribution to provider database accuracy and operations
What to Expect (Job Responsibilities):
- Generate and prepare provider-related data and reports to support Network Management and Operations
- Provide timely and accurate reports to ensure compliance with regulatory requirements and business operations
- Develop and maintain documentation and guidelines for assigned responsibilities
- Execute quality assurance and maintenance of supporting tables for provider-related directories
- Conduct claims report extractions and generate mailing labels as needed
What is Required (Qualifications):
- Bachelor’s Degree or equivalent combination of education and experience
- 3-5 years of managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration
- 3+ years of experience in Medical Terminology, CPT, ICD-9 codes, etc.
- Intermediate skill level or higher in Access and Excel
How to Stand Out (Preferred Qualifications):
- 5+ years of managed care experience
- Experience with QNXT and SQL
- Proficiency in Crystal Reports for data extraction
#ManagedCare #HealthcareAdministration #ProviderNetwork #CareerGrowth #DataManagement
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