PROVIDER NETWORK MANAGER jobs in Colorado
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
Senior Provider Network Contractor
- Colorado Access
-
Aurora, CO
CONTRACTOR
- Why should you consider a career with Colorado Access? We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP ) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion. Find work/life balance: We offer PTO, floating holidays, seven company paid holidays, work from home options (exceptions apply), an Employee Assistance Program and a 401K. Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference. Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend. What you will do: We are looking for a Senior Provider Network Contractor who can help shape our vision and support our mission. Here is what the position will look like. Negotiates complex provider agreements utilizing a variety of negotiation strategies and techniques with all provider types, with emphasis on developing strategic partnerships with facilities, health systems, integrated care delivery systems, physician hospital organizations, independent practice associations, individual providers and clinics, ancillary providers, FQHCs and other providers. . Maintains proficiency in current and proposed reimbursement methodologies for facility and professional contracts, contract language and provisions and organizational operations to assure contract offers can be implemented and effectively administered. Provides comprehensive management of the contracting process, including rate and language negotiations, and operational implementation. Works with contracted providers on contract interpretation and assists with operational and/or reimbursement issue resolution. Serves as the project lead and subject matter expert for one or more of the following: Development and revision of multiple contract templates for contract management system, in collaboration with the Director, and software vendor Fee schedule analysis Appropriate billing and coding for physical and behavioral health Serves as contract management system administrator as assigned Works with legal and other staff to resolve complex claims issues Provides financial and operational performance analysis of existing and pending Provider contracts. Provides guidance, support and direction to Managed Care Contractors and other department staff as needed. Participates in Lines of Business financial operational meetings as assigned by Director. What you will bring: Education: Bachelor’s degree in health administration, business administration or related field required with a Masters’ degree preferred. Any combination of education or experience may be substituted for education or experience. Experience: Five to eight years’ experience negotiating complex contracts with health care providers (e.g., hospitals, health systems, medical groups, clinics). Experience with strategic planning; development, revision and quality control of contract templates, contracting guidelines; determination of network adequacy and capacity standards and other policies and procedures Knowledge, Skills, and Abilities: Working knowledge of the various medical reimbursement platforms including the Resource Based Relative Value System, Diagnostic Related Groups, and Medicaid reimbursement required. Demonstrates support for the company’s mission, vision and values. Must have excellent negotiation skills and techniques and knowledge of current negotiation strategies. Position requires excellent written, verbal and public speaking communication skills. Requires training, project development and management skills. Advanced knowledge of managed care contracting, provider reimbursement and claims payment, medical terminology, and health care delivery systems required. Knowledge of local health and community agencies and providers preferred. Strong attention to detail with ability to handle multiple tasks simultaneously required. Ability to deal with multiple levels of staff. Must be able to handle high volume workload. Ability to work independently with little direction and initiate work priorities. Must be proficient in MS-Office applications (Word, Excel, and Access). May be required to manage multiple priorities and projects with tight deadlines. Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving. Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization. Pay, Perks and Benefits at Colorado Access: The compensation for this position is $90,180.00 - $108,220.00 annually. The pay rate/salary is commensurate with experience. In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes: Medical, dental, vision insurance that starts the first day of the month following start date. Supplemental insurance such as critical illness and accidental injury. Health care and dependent care flexible spending account options. Employer-paid basic life insurance and AD&D (employee, spouse and dependent). Short-term and long-term disability coverage. Voluntary life insurance (employee, spouse, dependent). Paid time off Retirement plan Tuition reimbursement (based on eligibility). Annual bonus program (based on eligibility, requirements and performance). Where you will work: This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’ We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.
- 30 Days Ago
Primary Care Office Manager
- Preferred Provider Services
-
Aurora, CO
FULL_TIME
- Company Overview Preferred Provider Services is seeking an office manager to join our growing team in Aurora, CO! ********************************************************************** Job Type Full-t...
- 1 Month Ago
Network Manager
- Diverse Lynx
-
Englewood, CO
CONTRACTOR
- Job Tittle: Network ManagerLocation: Englewood CO (Remote)SummaryTop Skills RequestedF5 Load BalancerCisco ASA FirewallCisco FirepowerCheckpointCisco Routing & SwitchingCisco ACIRoles/Responsibilities...
- 23 Days Ago
Sanitation Manager
- LaSalle Network
-
Denver, CO
FULL_TIME
- Our client, an industry-leading food company, is seeking a Sanitation Manager for their state-of-the-art manufacturing plant with top-of-the-line technology. This industry-disrupting company is contin...
- Just Posted
Plant HR Manager
- LaSalle Network
-
Westminster, CO
FULL_TIME
- Our client is a leading manufacturing company committed to delivering high-quality products and solutions to their customers. With a strong focus on innovation and sustainability, they strive to creat...
- 2 Days Ago
Restaurant Assistant General Manager
- The Sustain Network
-
Denver, CO
FULL_TIME,PART_TIME
- **Salary is $20-$26/hr depending on experience and location** The Sustain Network is a restaurant and hospitality consulting firm representing an undisclosed client in your area. Our clients has ambit...
- 3 Days Ago
PROVIDER NETWORK MANAGER jobs at Popular Companies
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...
- 6/11/2024 12:00:00 AM
Provider Network Manager Sr
- Elevance Health
-
Manchester, NH
- Anticipated End Date: 2024-07-31 Position Title: Provider Network Manager Sr Job Description: Location: NH-Manchester, M...
- 6/10/2024 12:00:00 AM
Service Provider Manager (SPM) (Referral Management Clerk) - Eglin AFB, FL
- Reef Systems
-
Eglin Afb, FL
- Service Provider Manager (SPM) (Referral Management Clerk) - Eglin AFB, FL Background/Experience : Shall read, understan...
- 6/10/2024 12:00:00 AM
Director of Provider Engagement
- Tandym Group
-
New York, NY
- A health services organization in New York City is currently seeking an experienced professional to join their staff as ...
- 6/10/2024 12:00:00 AM
Strategic Account Executive
- Virsys12
-
- Strategic Sales Account Executive, Salesforce.com and Healthcare Consulting Practice and SAAS Software V12 Network Virsy...
- 6/10/2024 12:00:00 AM
Provider Network Manager
- Elevance Health
-
Miami, FL
- Anticipated End Date: 2024-06-18 Position Title: Provider Network Manager Job Description: Provider Network Manager (JR1...
- 6/9/2024 12:00:00 AM
Provider Network Manager
- Devoted Health
-
Cincinnati, OH
- At Devoted Health, we're on a mission to dramatically improve the health and well-being of older Americans by caring for...
- 6/8/2024 12:00:00 AM
Dental Provider Network Manager (Client Relations Healthcare/Dental)
- LIBERTY Dental Plan
-
- Building Brighter Futures, One Smile at a Time! LIBERTY Dental Plan is seeking an experienced Dental Provider Network Ma...
- 6/7/2024 12:00:00 AM
About Colorado
Colorado (/ˌkɒləˈrædoʊ, -ˈrɑːdoʊ/ (listen), other variants) is a state of the Western United States encompassing most of the southern Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains. It is the 8th most extensive and 21st most populous U.S. state. The estimated population of Colorado was 5,695,564 on July 1, 2018, an increase of 13.25% since the 2010 United States Census.
The state was named for the Colorado River, which early Spanish explorers named the Río Colorado for the ruddy silt the river carried from the mountains. The...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for PROVIDER NETWORK MANAGER jobs
$110,337 to $138,246
Most Popular Cities in Colorado 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