Provider Network Director jobs in Virginia

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)

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Provider Network Quality Assurance Coordinator
  • CorVel Corporation
  • Allen, VA FULL_TIME
  • The Provider Network Quality Assurance Coordinator is responsible for supporting initiatives that promote the quality of CorVel’s Provider Network. This role is crucial in maintaining compliance and integrity of the network, which affects the care and satisfaction of patients and stakeholders within the organization.


    ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

    • Triage and Handling - Manage queue for incoming work, address and resolve any issues related to provider network quality promptly.
    • Effectively communicate with network providers, CorVel staff and stakeholders to collect pertinent information for quality investigations.
    • Maintain records and documentation related to provider network quality and compliance.
    • Generate and send formal written notification of committee decisions and case resolutions.
    • Prepare files and summarize any issues to be presented to the quality assurance committee.
    • Provide guidance to network providers at the direction of the quality assurance committee.
    • Ensure that providers adhere to relevant regulations and quality standards.
    • Monitor patient feedback and address concerns related to network provider quality.
    • Collaborate with various departments to optimize the provider network.
    • Analyze data related to provider performance, patient outcomes and satisfaction.
    • Research as needed and keep up to date with applicable regulatory standards, quality assurance program, and standard operating procedures.
    • Comply with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).
    • Regular and consistent attendance.
    • Additional projects and duties as assigned.

    KNOWLEDGE & SKILLS:

    • Excellent written and verbal communication skills.
    • Ability to learn rapidly to develop knowledge and understanding of applicable regulatory standards.
    • Ability to identify, analyze and solve problems.
    • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
    • Strong interpersonal, time management and organizational skills.
    • Ability to work both independently and within a team environment.

    EDUCATION/EXPERIENCE:

    • Highschool Diploma or equivalent
    • Minimum of 2 years prior customer service experience within the insurance industry, managed care, or related field.

    PAY RANGE:

    CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

    For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

    Pay Range: $21.12 - $31.55 per hour

    A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management


    ABOUT CORVEL:

    CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

    A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

    CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

  • 8 Days Ago

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Provider Network Quality Assurance Coordinator
  • CorVel Brand
  • Allen, VA FULL_TIME
  • The Provider Network Quality Assurance Coordinator is responsible for supporting initiatives that promote the quality of CorVel’s Provider Network. This role is crucial in maintaining compliance and i...
  • 8 Days Ago

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Advanced Practice Provider
  • US Oncology Network-wide Career Opportunities
  • Blacksburg, VA FULL_TIME
  • OverviewUnder supervision or in collaboration with practice physicians, involved in the care of individuals, families and patient groups who are dealing with cancer or other related diagnosis. This ca...
  • Just Posted

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Regional Director of Network Development
  • Marquis Health Consulting Services
  • , VA FULL_TIME
  • Regional Director of Network Development-Northern VA area Please have SNF experience Marquis Health Consulting Services continues to grow and we are adding a Regional Director of Network Development t...
  • 20 Days Ago

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Director, Network Operations
  • Integral Federal, Inc
  • Tysons Corner, VA FULL_TIME
  • Director, Network Operations Job Locations US-VA-Tysons Corner # of Openings 1 Category Information Technology Clearance None Overview OverviewDirector, Network OperationsLocation: Tysons Corner, VACl...
  • 20 Days Ago

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Director - Network Systems
  • Peraton
  • Herndon, VA FULL_TIME
  • Responsibilities Peraton is seeking an experienced Network Engineering Director with demonstrated design, deployment, and operations of large transport network. The Director will oversee Network Opera...
  • 24 Days Ago

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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...
  • 3/28/2024 12:00:00 AM

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Director of Network and Endpoint Security | Industrial Cybersecurity Consulting - 1898 & Co. (Multiple Locations)
  • Burns & McDonnell
  • Greenville, SC
  • **Description** 1898 & Co. is looking for its next leader within the Security & Risk Consulting group focused on helping...
  • 3/28/2024 12:00:00 AM

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Director of Network and Endpoint Security | Industrial Cybersecurity Consulting - 1898 & Co. (Multiple Locations)
  • Burns & McDonnell
  • Austin, TX
  • **Description** 1898 & Co. is looking for its next leader within the Security & Risk Consulting group focused on helping...
  • 3/28/2024 12:00:00 AM

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Director of Network and Endpoint Security | Industrial Cybersecurity Consulting - 1898 & Co. (Multiple Locations)
  • Burns & McDonnell
  • Phoenix, AZ
  • **Description** 1898 & Co. is looking for its next leader within the Security & Risk Consulting group focused on helping...
  • 3/28/2024 12:00:00 AM

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Director of Network and Endpoint Security | Industrial Cybersecurity Consulting - 1898 & Co. (Multiple Locations)
  • Burns & McDonnell
  • Houston, TX
  • **Description** 1898 & Co. is looking for its next leader within the Security & Risk Consulting group focused on helping...
  • 3/28/2024 12:00:00 AM

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Director of Network and Endpoint Security | Industrial Cybersecurity Consulting - 1898 & Co. (Multiple Locations)
  • Burns & McDonnell
  • Chicago, IL
  • **Description** 1898 & Co. is looking for its next leader within the Security & Risk Consulting group focused on helping...
  • 3/28/2024 12:00:00 AM

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EXECUTIVE DIRECTOR OF NETWORK INFRASTRUCTURE & INTEGRITY
  • City of New York
  • New York, NY
  • Job Description APPLICANTS MUST BE PERMANENT IN THE COMPUTER SYSTEMS MANAGER CIVIL SERVICE TITLE. The Department of Soci...
  • 3/27/2024 12:00:00 AM

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Network Director Strategic Sourcing, MWBE and Supplier Diversity
  • Westchester Medical Center, a member of WMCHealth
  • Valhalla, NY
  • Salary : $145,466-$184,134 Job Summary: The Network Director Strategic Sourcing, MWBE and Supplier Diversity is responsi...
  • 3/25/2024 12:00:00 AM

Virginia (/vərˈdʒɪniə/ (listen)), officially the Commonwealth of Virginia, is a state in the Southeastern and Mid-Atlantic regions of the United States located between the Atlantic Coast and the Appalachian Mountains. Virginia is nicknamed the "Old Dominion" due to its status as the first English colonial possession established in mainland North America and "Mother of Presidents" because eight U.S. presidents were born there, more than any other state. The geography and climate of the Commonwealth are shaped by the Blue Ridge Mountains and the Chesapeake Bay, which provide habitat for much of ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$172,047 to $222,276

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