Provider Network Specialist jobs in Clearwater, FL

Provider Network Specialist coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Provider Network Specialist - BayCare Health Plans
  • BayCare
  • Clearwater, FL FULL_TIME
  • At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

    Summary:
    The Provider Network Specialist for the Health Plan monitors CMS provider access standards, assists with provider orientation and training, and coordinates with the outsource Vendor and insource Department Leads to resolve provider issues. Responsible for provider network delivery to vendors. Coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Distributes contract information, status updates, and other information within the organization. Collaborates with Compliance for provider directory audits, as needed. Collaborates with Credentialing Team to ensure contracted provider files are routed correctly for approval. Maintains master provider network list for distribution to provider directory vendor and other internal departments, as needed. Assists with Provider Network committees, as needed. Required experience includes 3 years provider relations and Medicare Advantage contracting.

    Minimum Qualifications:

    Other information:
    Required - 3 years - Reference summary for details; Preferred - 2 years - Data Analytics
    Education:
    Essential:
    • Education Requirements in Comments

    Education equivalent experience:
    Essential:
    • Required - Bachelors - Business; Or - Bachelors - Healthcare Administration


    Facility:

    BayCare Health System, Tampa Startup-BHS

    Location: BayCare System Office West

    Status: Full Time, Exempt: Yes

    Shift Hours: 8:00 AM - 4:30 PM


    Shift: Shift 1

    Shift 1 = Days, 2 = Evenings, 3 = Nights, 4 = Varies

    Weekend Work: None


    On Call:
    No

    Does this position fall under CMS guidelines for COVID19 vaccine or exemption?: Yes - CMS Requirements Apply


    How often will this team member be working remotely?
    Hybrid

    Equal Opportunity Employer Veterans/Disabled

  • 10 Days Ago

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Manager Provider Network Health Plan
  • BayCare
  • Clearwater, FL FULL_TIME
  • At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatie...
  • 3 Days Ago

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Provider specialist
  • Integrity Marketing Group
  • Clearwater, FL FULL_TIME
  • Integrity is one of the nation's leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving ag...
  • 21 Days Ago

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Network Access Center Specialist
  • AdventHealth Medical Group West FL
  • Palm Harbor, FL FULL_TIME
  • Description All the benefits and perks you need for you and your family: Benefits from Day One Paid Days Off from Day One Student Loan Repayment Program Career Development Whole Person Wellbeing Resou...
  • 10 Days Ago

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Medical Office Specialist
  • HCA FL Bayonet Surg Specialist
  • Hudson, FL FULL_TIME
  • Introduction Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Medical Office Specialist opening with HCA FL Bayonet Surg Specialist today an...
  • 1 Month Ago

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Medical Assistant
  • HCA FL Bayonet Surg Specialist
  • Hudson, FL FULL_TIME
  • Introduction Do you have the career opportunities as a(an) Medical Assistant you want with your current employer? We have an exciting opportunity for you to join HCA FL Bayonet Surg Specialist which i...
  • 1 Month Ago

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0 Provider Network Specialist jobs found in Clearwater, FL area

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Network Engineer
  • Insight Global
  • Tampa, FL
  • Must-Haves: 8+ years of experience with managing enterprise firewall solutions/network engineering Strong experience wit...
  • 3/28/2024 12:00:00 AM

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Network Engineer - W2
  • Hire IT People, Inc
  • Tampa, FL
  • "W2 preferred" Network Engineer - Intermediate - Tampa, FL - 298791 Work Location: Tampa, FL (looking for local candidat...
  • 3/28/2024 12:00:00 AM

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Network Engineer
  • Bold Business
  • Thonotosassa, FL
  • Looking for an exciting career in Telecom? We are Bold Business, a US-based leading solutions company in the telecommuni...
  • 3/28/2024 12:00:00 AM

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Senior Network Engineer
  • Paragon IT Professionals
  • Tampa, FL
  • Paragon IT Professionals is seeking a Senior Network Engineer for a regular, full time role. This is a remote position, ...
  • 3/28/2024 12:00:00 AM

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Senior Network Engineer
  • Ashley Furniture Industries
  • Tampa, FL
  • Join The #1 Furniture Company-Join The #1 Furniture Brand Ashley Furniture Industries, Inc. is the largest manufacturer ...
  • 3/28/2024 12:00:00 AM

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Network Engineer
  • MiSource
  • Tampa, FL
  • Responsibilities Maintain network servers and associated hardware, software, services, and settings Recommend, test, and...
  • 3/27/2024 12:00:00 AM

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Network Engineer
  • Bering Straits Native Corporation (BSNC)
  • Tampa, FL
  • Overview: Visit our website at www.beringstraits.com to apply! Equal Opportunity Employer/Veterans/Disabled SUMMARY Beri...
  • 3/26/2024 12:00:00 AM

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Senior Network Engineer
  • World Wide Technology
  • Tampa, FL
  • World Wide Technology Holding Co, LLC. (WWT) has an opportunity available for a Network Engineer/Administrator in Tampa,...
  • 3/26/2024 12:00:00 AM

Clearwater is a city located in Pinellas County, Florida, United States, northwest of Tampa and St. Petersburg. To the west of Clearwater lies the Gulf of Mexico and to the southeast lies Tampa Bay. As of the 2010 census, the city had a population of 107,685. Clearwater is the county seat of Pinellas County and is the smallest of the three principal cities in the Tampa-St. Petersburg-Clearwater metropolitan area, most commonly referred to as the Tampa Bay Area. Cleveland Street is one of the city's historic avenues, and the city includes Spectrum Field and Coachman Park. The city is separated ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$55,753 to $83,377
Clearwater, Florida area prices
were up 1.1% from a year ago

Provider Network Specialist in Springfield, MO
As the liaison between provider and the health plan, candidates are tasked with ensuring improved revenue generated and patient quality score.
December 16, 2019
Provider Network Specialist in Stamford, CT
Previous experience in a network development, provider recruitment or provider contracting.
December 04, 2019
Provider Network Specialist in Fort Wayne, IN
In this position, employees will be expected to perform benefits analysis and create reports on provider performance to support the needs of the analysis found.
January 18, 2020