Provider Network Director jobs in Mississippi
Provider Network Director directs and develops a healthcare provider network. Designs and administers policies and services that comply with all contractual and regulatory requirements. Being a Provider Network Director requires a bachelor's degree. Typically reports to top management. The Provider Network Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Provider Network Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added Provider Network Director jobs
BlueAdvantage Network Provider Consultant
- Blue Cross & Blue Shield of Mississippi
-
Flowood, MS
FULL_TIME
- Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. Job Summary The BlueAdvantage Network Provider Consultant serves as a consultant and corporate liaison to BlueAdvantage Network Providers, including, but not limited to professional, facility, and allied providers. This role provides consultative services to the BlueAdvantage Network Provider community to ensure compliance with BlueAdvantage contracts and performance expectations. This includes sharing of Network Provider performance against BlueAdvantage requirements, Centers of Medicare and Medicaid Services (CMS) rules for STARS ratings and clinical improvement of patients to include HEDIS improvement and gaps in care closure. The BlueAdvantage Network Provider Consultant will also be responsible for ensuring Network Provider compliance to improve administrative and clinical efficiency/effectiveness to assist in providing the highest quality and most cost effective healthcare to BlueAdvantage Members. Job-Specific Requirements: · A Bachelor’s degree in Business Administration, Health Administration, or Nursing. · At least three (3) years of professional healthcare experience and must possess knowledge of member and provider contract benefits, clinical guidelines, medical policy and claims processing for designated line(s) of business, or possess equivalent healthcare related industry knowledge. · Medicare Advantage benefit plans experience. · Experience in working with healthcare providers on improvement in Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. · Experience with and knowledge of Medicare STARS program to measure health plan and healthcare provider performance. · Knowledge of the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk adjustment model. · Exhibits professional and positive demeanor with excellent communication. · Excellent verbal and written communication skills including exemplary presentation skills, development of correspondence, review and management of performance documents etc. · Ability to travel throughout the state to meet with BlueAdvantage Network Providers. · Demonstrated proficiency in Microsoft Office Suite, especially Excel, Word and PowerPoint. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers. At Blue Cross & Blue Shield of Mississippi, we work daily to help Mississippians find their personal answers to this question through health and wellness partnerships with quality healthcare providers, employer groups and community leaders across the state. Our goal is to help each person along their journey to a healthier life… their Blue Wellness Journey. Our health and wellness benefits are designed to support our members in understanding their health and in receiving the care they need at the right time and place, beginning with establishing a healthy relationship with a Primary Care Network Provider through an annual wellness visit at no out-of-pocket cost. We partner with our Network Providers to ensure the highest quality, evidence-based care is provided in each care setting from primary care to specialty care through our Primary Care Home, Blue Distinction Centers of Excellence and Maternity Care Quality initiatives. We partner with employer groups to make every workplace a healthy workplace by providing tools and information to help employees take ownership of their health and understand and make the most of their benefits, all while working to manage health and healthcare costs. We partner with community leaders and organizations to make healthy living resources available to all Mississippians through the work of the Blue Cross & Blue Shield of Mississippi Foundation, our support of the arts and culture and our Team Blue volunteers. These partnerships and our dedicated team of employees are making a difference every day, in our communities and in the lives of each person we reach. So, what does it mean to be healthy? The answer is about you, your health, your life… and all its possibilities. Live healthy. Live Blue.
- 1 Month Ago
Sr. Network Management Service Provider
- NovaLink Solutions
-
Jackson, MS
FULL_TIME
- Job DetailsJob Description: Required Experience Network Management ExpertiseProven experience in providing network management services, with a track record of successful client engagements.Demonstrate...
- 3 Days Ago
Mississippi First - Deputy Director
- Deputy Director - Daniels Solutions
-
Jackson, MS
FULL_TIME
- About Mississippi FirstMississippi First was founded in 2008 by Rachel Canter and her childhood friend, Sanford Johnson. Driven to change the fact that Mississippi has historically been last, our foun...
- 1 Month Ago
Caregiver
- The Goode Provider
-
Southaven, MS
FULL_TIME
- Responsible for administrative as well as clinical tasks, such as maintaining patient records, preparing patients and rooms for examination, assisting providers with exams, and performing front-desk t...
- 18 Days Ago
Sales Executive, Northern Mississippi
- Provider's Choice Laboratory
-
Northern Mississippi, MS
FULL_TIME
- Sales Executive Physicians' Group Laboratories is a new generation of laboratory testing and patient care. We provide PCR diagnostic laboratory testing and service providers across the entire state of...
- 6 Days Ago
Network Analyst
- Jackson Public Schools
-
Jackson, MS
FULL_TIME
- Network Analyst QUALIFICATIONS Bachelor's or associate’s degree in a relevant field such as computer science, information technology, or a related discipline is preferred. Work experience with end-use...
- 15 Days Ago
Provider Network Director jobs at Popular Companies
Network Director of Operations
- Seton Education Partners
-
New York, NY
- Job Description Job Description Network Director of Operations, Brilla NY Brilla Schools Network Seton Education Partner...
- 4/23/2024 12:00:00 AM
2024-2025 Network Director of Special Education
- Crescent City Schools
-
New Orleans, LA
- Job Description Job Description The Network Director of Special Education impacts students’ lives by: Embodying, advocat...
- 4/23/2024 12:00:00 AM
Director of Networking
- World Wide Technology
-
Houston, TX
- Director of Network and Technology Services 6 Months CTH Houston, TX / Hybrid. 2-3 days a week onsite I. Job Summary The...
- 4/22/2024 12:00:00 AM
Director, Change Network and Site Readiness - Remote
- Lifepoint Health Support Center
-
Brentwood, TN
- Who we are: At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our team, you...
- 4/22/2024 12:00:00 AM
Director, Engineering & Network Infrastructure - Wells Fargo Center
- Comcast Corporation
-
Philadelphia, PA
- Make your mark at Comcast -- a Fortune 30 global media and technology company. From the connectivity and platforms we pr...
- 4/22/2024 12:00:00 AM
Director, ACH Network Development
- Nacha
-
Herndon, VA
- Job Title:Director, ACH Network Development Date: April 2024 Department: ACH Network Development Status: Full-time/Exemp...
- 4/21/2024 12:00:00 AM
Director of Networking
- World Wide Technology
-
Houston, TX
- Director of Network and Technology Services 6 Months CTH Houston, TX / Hybrid. 2-3 days a week onsite I. Job Summary The...
- 4/20/2024 12:00:00 AM
Executive Assistant to the Director - Information Networking Institute
- Carnegie Mellon University
-
Pittsburgh, PA
- The Information Networking Institute (INI) at Carnegie Mellon University (CMU) educates and develops engineers through t...
- 4/19/2024 12:00:00 AM
About Mississippi
Mississippi is bordered to the north by Tennessee, to the east by Alabama, to the south by Louisiana and a narrow coast on the Gulf of Mexico; and to the west, across the Mississippi River, by Louisiana and Arkansas.
In addition to its namesake, major rivers in Mississippi include the Big Black River, the Pearl River, the Yazoo River, the Pascagoula River, and the Tombigbee River. Major lakes include Ross Barnett Reservoir, Arkabutla Lake, Sardis Lake, and Grenada Lake with the largest lake being Sardis Lake.
Mississippi is entirely composed of lowlands, the highest point being Woodall Mountai...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$154,760 to $199,939
Most Popular Cities in Mississippi for Provider Network Director Jobs
What does a Provider Network Director do?
Provider Network Director in Columbus, OH
In either scenario, taking these three steps can help you determine whether a network change will genuinely lower your costs.
February 09, 2020
Provider Network Director in Portland, ME
We offer providers a value-based reimbursement model centered on aligning quality measures, HEDIS measures and HH incentives to reward high-quality care of the members you serve.
December 12, 2019
Provider Network Director in Temple, TX
However, from a state regulator’s and the health plan’s perspective, the sheer number of providers in the network overall is only part of the story.
December 21, 2019