Top Provider Network Executive jobs in Florida
Top Provider Network Executive plans and directs all aspects of an organization's provider network function. Responsible for developing the network and negotiating and administering contracts. Being a Top Provider Network Executive oversees provider relations and monitors and directs all provider services. Requires a bachelor's degree. Additionally, Top Provider Network Executive typically reports to a top management. The Top Provider Network Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Provider Network Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Recently Added Top Provider Network Executive jobs
Provider Network Account Executive I
- AmeriHealth Caritas
-
Palm Beach Gardens, FL
FULL_TIME
-
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
The AE I is responsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers.AE I maintains an understanding of Plan’s contracts, provider performance and needs assisting in development of tailored provider orientation sessions, working to resolve provider issues. ;Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the Plan’s territory in keeping w/ State and Federal contract mandates for all products. Identifies, contacts and actively solicits qualified providers to participate in Plan at new and existing service areas and products, assuring financial integrity of the Plan is maintained and contract management requirements are adhered to, including language, terms and reimbursement requirements. ;Maintains complete understanding of Plan reports and metrics. ;Uses data to develop and implement methods to improve relationships. ;Assists in corrective actions required up to and including termination, following Plan policies and procedures. Corporate credentialing department with the credentialing and re-credentialing processes, investigation of member complaints, assists quality and grievance department with potential quality or service issues. ;Maintains a functional working knowledge of Facets, including the provider database and routinely relays information about additions, deletions, or corrections to the Provider Maintenance Department. Maintains and delivers accurate, timely activity and metric reports as required. ;Identifies and maintains strong partnerships with appropriate internal resources and stakeholders.
Education/Experience:- Bachelor's degree or equivalent education and experience.
- High School Diploma/GED required.
- Problem-solving skills with an emphasis on conflict resolution preferred.
- 1 to 3 years' experience in a Provider Relations position working with Physicians, Hospitals and Ancillary provider types.
- 3 to 5 years' experience in the managed care/health insurance industry.
- Medicaid experience preferred.
- Medicare experience preferred.
- Credentialing experience preferred.
- Demonstrated strength in working independently, establishing influential relationships internally and externally, meeting and training facilitation skills, priority setting and problem-solving skills.
- Must be proficient in MS Office: Excel, Word, Teams & other applications (we will train you).
- Valid driver's license and automobile insurance required.
- Provider Relations services for this position will cover Miami Dade, Broward, and Palm Beach counties.;
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. - 4 Days Ago
Provider Network Account Executive I
- AmeriHealth Caritas Health Plan
-
Palm Beach Gardens, FL
FULL_TIME
- Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities....
- 16 Days Ago
Sales Advisor - Inside Sales
- Top Provider, LLC.
-
Naples, FL
FULL_TIME
- Job Overview:Top Provider is seeking a motivated and enthusiastic Sales Advisor to join our innovative and dynamic team in Naples, FL. As a fast-growing startup, we connect business professionals with...
- 22 Days Ago
Network Administrator
- Top Stack
-
Orlando, FL
FULL_TIME
- We are looking for a strong candidate who can maintain Helpdesk and Network support for a complex virtualized system in a DoD training platform. This in-office position allows for remote work when nee...
- 1 Day Ago
Business Development Executive
- Top Talent
-
Beach, FL
FULL_TIME
- Location: West Palm Beach, FLPosition Type: On-site preferred, remote considered for exceptional candidatesSalary: $50,000 - $120,000Commission/Bonus Structure: 6.5% Hunt, 13% Hunt & FarmBenefits: Hea...
- 9 Days Ago
Provider Network Manager
- Ultimate Health Plans
-
Sarasota, FL
FULL_TIME
- This position serves the West Central Florida (Sarasota Manatee counties) you must be based in that area. 50% local travel to visit current and potential network providers will be required. Out of sta...
- 1 Day Ago
Top Provider Network Executive jobs at Popular Companies
Sales Executive - Employee Benefits
- AssuredPartners
-
- Overview Love what you do but not where you do it? As a Sales Executive at AssuredPartners, you will use your existing s...
- 6/11/2024 12:00:00 AM
Account Executive - Employee Benefits
- Marsh McLennan Agency
-
Aliso Viejo, CA
- Client Service Executive Summary Responsible for retention of existing business and the development of business within t...
- 6/10/2024 12:00:00 AM
Account Executive - Employee Benefits (26725)
- Dahl Consulting
-
Salem, OR
- Dahl Consulting is currently partnering with a leader in the insurance industry. We work one-on-one with great candidate...
- 6/10/2024 12:00:00 AM
Account Executive, Employee Benefits
- HUB International
-
Wichita, KS
- Primary Role: The Employee Benefits Account Executive is expected to contribute to the retention and growth of the emplo...
- 6/9/2024 12:00:00 AM
Account Executive - Employee Health and Benefits
- Marsh McLennan Agency
-
Dallas, TX
- ESSENTIAL DUTIES & RESPONSIBILITIES: Primary Contact with the Producer Manage the Client Insurance Program, utilizing ag...
- 6/9/2024 12:00:00 AM
Insurance Sales Executive - Employee Benefits
- AAA Club Alliance, Inc.
-
Maumee, OH
- Dedicated Account Management Team to service your book, so you can focus on selling Ability to quote through multiple ca...
- 6/8/2024 12:00:00 AM
Account Executive-Employee Benefits
- National Financial Partners Corp.
-
Palm Beach Gardens, FL
- Who We Are NFP is a seven-time Best Places to Work award winner in Business Insurance who has also earned the 5-Star Div...
- 6/7/2024 12:00:00 AM
Senior Account Executive - Employee Benefits
- Confidential
-
Alpharetta, GA
- SUMMARY: Retain clients through servicing and management of client relationships both internally and externally. Collabo...
- 6/7/2024 12:00:00 AM
About Florida
Florida (/ˈflɒrɪdə/ (listen); Spanish for "land of flowers") is the southernmost contiguous state in the United States. The state is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Atlantic Ocean, and to the south by the Straits of Florida. Florida is the 22nd-most extensive (65,755 sq mi or 170,300 km2), the 3rd-most populous (21,312,211 inhabitants), and the 8th-most densely populated (384.3/sq mi or 148.4/km2) of the U.S. states. Jacksonville is the most populous municipality in the state and the largest city by area in th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Top Provider Network Executive jobs
$377,822 to $699,646