Network Control Center Director jobs in Miami, FL
Network Control Center Director directs activities of the network control function of the organization. Determines quality levels for network transmission and performance and ensures levels are met. Being a Network Control Center Director requires a bachelor's degree in area of specialty. Typically reports to top management. The Network Control Center 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 Network Control Center Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added Network Control Center Director jobs
- DOCTORS HEALTHCARE PLANS, INC.
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Coral, FL
FULL_TIME
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Job Purpose: This leadership position is responsible for all activities related to developing, maintaining and expanding the networks of providers. Develop, administer and negotiate physician, medical group, ancillary, hospital and vendor agreements in compliance with all regulatory state and federal guidelines.
Key Responsibilities:
- Responsible for ensuring that the language of all contracts is in compliance with all State, CMS, AHCA, and any other regulatory agency.
- Responsible for developing, administrating and negotiating Provider Agreements for Primary Care Physician Services, Medical Specialty Care Services, Ancillary Care Services and Hospital Services.
- Responsible for negotiation of settlement agreements for all providers.
- Responsible for all limited or interim agreements of non-participating providers.
- Performs analysis to determine the needs of the existing networks
- Determining the forms of payment, i.e., capitation, FFS or trade agreements depending on financial impact.
- Ensuring that the networks are cost effective, marketable, stable, and offer broad access to members.
- Responsible for negotiating amendments to contracts
- Responsible for overseeing the provider data base system
- Responsible for performing claims and utilization research for re contracting existing network providers
- Comparative analysis of potential providers.
- Responsible for maintaining Contract Library.
- Responsible for overseeing the processing of all contracts.
- Responsible for ensuring accuracy of the provider database and provider directory.
- Responsible for developing and coaching the Network Development Department, Contract administration Department and Contract Library.
- Performs other job related duties as assigned from time to time by the VP Network Development and/or President/CEO
Qualifications:- Excellent negotiation skills
- Excellent oral and written communication skills
- BS/BA Degree and 4 to 6 years of work experience in the health administration field with progressively more responsible Health Care Administration experience with strong preference for managed care experience.
- A minimum of 4 years in a leadership role
- Demonstrates a broad-scope of financial knowledge
- Knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA and other federal and state regulatory guidelines
- Excellent organizational and customer skills
- Versatility
- Excellent customer skills
- Ability to work well under pressure and difficult situations
- Capable of managing a variety of complex issues while driving momentum of key initiatives
- Excellent knowledge and management of risk relationships
Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.
No Third Party Agencies or Submissions Will Be Accepted.
Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP
Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein. - 1 Month Ago
- Independent Living Systems
-
Miami, FL
FULL_TIME
- ABOUT US Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiar...
- 1 Month Ago
- Family Action Network Movement
-
Miami, FL
FULL_TIME
- The Director of Programs oversees the administration and coordination of all aspects of FANM's programs, including planning, organizing, staffing, leading, reporting to funders, and controlling progra...
- 6 Days Ago
- Health Choice Network Inc
-
Miami, FL
FULL_TIME
- Well established healthcare system in S. Florida is seeking a Director, Quality Assurance with significant experience working in Certified Community Behavioral Health Clinic environments. This individ...
- Just Posted
- Miccosukee Tribe of Indians of Florida
-
Miami, FL
FULL_TIME
- PC/Network Technician resolves problems by providing support and troubleshooting for the networked desktop environment, assists and trains users in basic operation of hardware and software needed for ...
- 1 Month Ago
- Principal Financial Group
-
Miami, FL
FULL_TIME
- What You'll DoThis role leads and consults with financial professionals to help them build their skills and grow their practice. You'll also attract and develop top-tier talent to our Miami team; It i...
- Just Posted
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0 Network Control Center Director jobs found in Miami, FL area
- SHI International Corp.
-
Fort Lauderdale, FL
- Job Summary: The Enterprise Solutions Engineer?is a technology?generalist?working with larger customers and engaging in?...
- 4/23/2024 12:00:00 AM
- Contact Government Services, LLC
-
Hollywood, FL
- Relativity Senior Systems Administrator Employment Type: Full Time Department: Legal/IT We are seeking a Relativity Sr. ...
- 4/22/2024 12:00:00 AM
- VetJobs
-
Miami, FL
- Job Description ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qual...
- 4/22/2024 12:00:00 AM
- Brightwing
-
Fort Lauderdale, FL
- Job Title: Information Security Officer ISO Location: Fort Lauderdale, FL Job Type: Full Time Position Overview: We are ...
- 4/22/2024 12:00:00 AM
- AllClear.ai
-
Fort Lauderdale, FL
- This position requires employees to be in the Ft Lauderdale, FL office weekly Qualified candidates must be legally autho...
- 4/20/2024 12:00:00 AM
- Brightwing
-
Fort Lauderdale, FL
- Job Title: Information Security Officer “ISO” Location: Fort Lauderdale, FL Job Type: Full Time Position Overview: We ar...
- 4/19/2024 12:00:00 AM
- Harmony Plus LLC
-
Miami, FL
- Harmony Plus Staffing Solutions (Employment Agency) is seeking an Commercial Director to join our team in our office loc...
- 4/19/2024 12:00:00 AM
- Camillus House
-
Miami, FL
- JOB TITLE: Special Events Project Manager JOB DETAILS: This position is a key member of the Development team. The Specia...
- 4/19/2024 12:00:00 AM
About Miami, Florida
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