PROVIDER NETWORK MANAGER jobs in Mississippi
PROVIDER NETWORK MANAGER manages the operations of a healthcare provider network. Responsible for establishing and maintaining processes and systems to provide routine services to members including contract management and credentialing. Being a PROVIDER NETWORK MANAGER recruits, hires, trains, and measures performance of staff to provide effective and operations within budget. May be involved with the design and operations of database systems used to manage provider data and produce reports and analysis. Additionally, PROVIDER NETWORK MANAGER requires a bachelor's degree. Typically reports to top management. The PROVIDER NETWORK MANAGER typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a PROVIDER NETWORK MANAGER typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added PROVIDER NETWORK MANAGER 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...
- 4 Days Ago
QIDP- Case Manager
- Case Manager
-
Brookhaven, MS
FULL_TIME,PART_TIME
- POSITION PURPOSE: Responsible for the day-to-day delivery of individual support program services to assigned case load in accordance with Federal, State, and facility codes, regulations, guidelines an...
- 9 Days 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...
- 19 Days Ago
Automotive eCommerce Data Specialist
- Web Shop Manager
-
, MS
FULL_TIME,CONTRACTOR
- Position: Automotive eCommerce Data SpecialistOverview: As an Automotive eCommerce Data Specialist, you will play a pivotal role in optimizing our clients' online automotive retail platforms by levera...
- Just Posted
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...
- 7 Days Ago
PROVIDER NETWORK MANAGER jobs at Popular Companies
Provider Network Manager
- Elevance Health
-
West Des Moines, IA
- Location: Des Moines, IowaHours: Standard M FTravel: Hybrid role (1-2 days per week in office)Position Overview:Develops...
- 4/23/2024 12:00:00 AM
Provider Network Manager Sr
- Elevance Health
-
Indianapolis, IN
- Location: Must live within 50 miles of a PulsePoint office.Develops the provider network through contract negotiations, ...
- 4/23/2024 12:00:00 AM
Manager Provider Network Management
- AmeriHealth Caritas
-
Palm Beach Gardens, FL
- Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re pass...
- 4/22/2024 12:00:00 AM
Provider Network Manager
- Elevance Health
-
Costa Mesa, CA
- Anticipated End Date: 2024-05-01 Position Title: Provider Network Manager Job Description: Location: we are targeting an...
- 4/22/2024 12:00:00 AM
Manager Provider Network Management
- AmeriHealth Caritas
-
Dublin, OH
- Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are pa...
- 4/22/2024 12:00:00 AM
Director, Provider Network Management - Seattle, WA
- Cigna
-
Seattle, WA
- LOCATION: This position supports the Seattle, WA market. The Director, Provider Network Management serves as an integral...
- 4/22/2024 12:00:00 AM
Manager Provider Network Management
- AmeriHealth Caritas
-
Dublin, OH
- Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are pa...
- 4/20/2024 12:00:00 AM
Provider Network Manager
- Elevance Health
-
Walnut Creek, CA
- WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which ma...
- 4/20/2024 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 MANAGER jobs
$96,046 to $120,340
Most Popular Cities in Mississippi for PROVIDER NETWORK MANAGER Jobs
What does a PROVIDER NETWORK MANAGER do?
PROVIDER NETWORK MANAGER in Tucson, AZ
There are different Location Providers, which one is the most accurate? The GPS Provider or the Network Provider.
January 08, 2020
PROVIDER NETWORK MANAGER in Saint Louis, MO
Healthcare providers are continually struggling with the increasing pressure to cut down on patient costing, providing higher quality service, increased accessibility, etc.
January 10, 2020
PROVIDER NETWORK MANAGER in Norfolk, VA
5+ years of experience in a network management-related role, such as contracting or provider services.
February 05, 2020