PROVIDER NETWORK MANAGER jobs in Cincinnati, OH
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
Manager - Provider Relations (Network Strategy)
- EyeMed Vision Care
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Mason, OH
FULL_TIME
-
Requisition ID: 837269
Position:Full-Time
Total Rewards: Benefits/Incentive Information
There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same. And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.
Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.
If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.GENERAL FUNCTIONThe Manager, Network Strategy is responsible for leading projects, analytics, and day to day management to support the provider network and provider economics functions. The Manager will partner with the Provider Contracting team on initiatives to ensure the EyeMed Provider Agreement and associated fee schedules support the objectives of those initiatives. The Manager will provide recommendations to leadership and lead projects related to supporting provider escalations, recruiting & contracting efforts, custom network builds, and overall provider economics.
MAJOR DUTIES AND RESPONSIBILITIES- Lead and develop recommendations for high priority Provider Relations projects and initiatives related to network strategy and provider economics.
- Ensure recommendations align with organizational goals and other key stakeholders objectives.
- Partner with Provider Communications, Provider Experience, and Call Center teams to ensure network strategy initiatives are supported with appropriate provider communications and interactions.
- Identify opportunities for network simplification and work with internal stakeholders to implement recommendations.
- Partner with Sales and Account Management team to intake, analyze, and provide recommendations on Strategic Provider needs and custom network builds
- Partner with Configuration & Operations teams to launch new networks to support strategic client needs
- Establish and maintain regular leadership dashboards on network management, network health, and provider economics
- Lead efforts and provide recommendations to leadership on provider escalations, including but not limited to reimbursement increases, network adds, and change of ownership.
- Collaborate with Contracting and Operations teams in planning and design of contract management system enhancements
- Support departmental collaboration with Legal, Finance, Pricing, Operations, and Compliance to ensure understanding and compliance with provider agreements and associated fee schedules
BASIC QUALIFICATIONS- Bachelor’s Degree in Business or related field, or equivalent work experience
- 5 years of experience in business strategy, operations, contract management, or other related field
- Demonstrated success in problem solving, collaboration and communication
- Able to identify obstacles quickly and develop solutions that support the business
- Strong organizational and time management skills
- Strong critical thinking and data analysis skills
- Strong oral and written communication skills
- Advanced knowledge of Microsoft Office
PREFERRED QUALIFICATIONS- Experience in the healthcare industry / provider relations
- Knowledge and understanding of plan benefit designs, standards of administration, etc.,
- Self-motivated and works independently with minimal supervision
- Experience leading resolution to cross-functional issue resolution
- Business Objects reporting experience
Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts.
Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com.
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law. - 1 Month Ago
Manager - Provider Relations (Network Strategy)
- EssilorLuxottica
-
Mason, OH
FULL_TIME
- Requisition ID: 837269 Position:Full-Time Total Rewards: Benefits/Incentive Information There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the ...
- 1 Month Ago
Physician and Provider Relationship Manager
- 9000 Bon Secours Mercy Health Inc
-
Cincinnati, OH
FULL_TIME
- Thank you for considering a career at Bon Secours Mercy Health! Primary Function/General Purpose of Position The Physician and Provider Relationship Manager will actively engage with physicians, provi...
- 12 Days Ago
Operations Manager - Florence, KY
- Signode -Operations Manager
-
Florence, KY
FULL_TIME
- Operations Manager - Florence, KY Apply Now Description/Job Summary About Signode:With over $2B in revenue, 80 manufacturing facilities across 6 continents and over 9,000 employees worldwide, Signode ...
- 4 Days Ago
Human Resources Manager - Florence, KY
- Signode -Human Resources Manager
-
Florence, KY
FULL_TIME
- Human Resources Manager - Florence, KY Apply Now Description/Job Summary About Signode:With over $2B in revenue, 80 manufacturing facilities across 6 continents and over 9,000 employees worldwide, Sig...
- 6 Days Ago
Direct Support Professional (DSP)
- EBE Care Provider
-
Cincinnati, OH
PART_TIME
- IMMEDIATE PART TIME DIRECT SUPPORT PROFESSIONAL POSITION!! LOCATION :KENWOOD AREA HOURS: FRIDAY 10 P- SUNDAY 3P , OVERNIGHT SLEEP HOURS 12A-8A Roles and Job Descriptions: Direct Support Professional J...
- 22 Days Ago
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0 PROVIDER NETWORK MANAGER jobs found in Cincinnati, OH area
Director, Healthcare Foodservice
- HHS Culinary and Nutrition Solutions, LLC
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Cincinnati, OH
- Culinary Director, Healthcare Food Service Bench Position, May Require Travel Salary $80,000.00-90,000.00 Culinary Direc...
- 4/25/2024 12:00:00 AM
Director, Managing Director- 401K Relationship Manager
- Fidelity TalentSource LLC
-
Covington, KY
- Job Description: Role The Managing Director (MD) is entrusted with a book of business of defined contribution. The Manag...
- 4/25/2024 12:00:00 AM
Community Association Manager
- Towne Properties Asset Mgt Co
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Cincinnati, OH
- Job Type Full-time Description Love where you work. Towne Properties is a leader in the property management industry, vo...
- 4/22/2024 12:00:00 AM
Project Cost Coordinator
- DataField
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Cincinnati, OH
- Job Description Job Description Job description Position Summary: Under general supervision, responsibilities include co...
- 4/21/2024 12:00:00 AM
Client Engagement Director
- SLK Software Services Pvt LTD
-
Cincinnati, OH
- BASIC INFORMATION ON THE POSITION Position Name: Client Engagement Director Mandatory/Required Skills & Location Locatio...
- 4/21/2024 12:00:00 AM
SRE Shopper Insight Operations A&I Sr. Manager
- Procter & Gamble Company
-
Cincinnati, OH
- Job Location Cincinnati Job Description Welcome to P&Gs Sales Operations! Here, we partner with categories and customer ...
- 4/21/2024 12:00:00 AM
WDC Operations Manager
- Cincinnati State
-
Cincinnati, OH
- Job Description - WDC Operations Manager The Workforce Development Center (WDC) at Cincinnati State is the region's lead...
- 4/21/2024 12:00:00 AM
Project Manager
- Centennial, Inc.
-
Cincinnati, OH
- Do you possess expertise in contract negotiation and administration? Are you acquainted with experience in aerospace/def...
- 4/21/2024 12:00:00 AM
About Cincinnati, Ohio
Cincinnati (/ˌsɪnsɪˈnæti/ SIN-sih-NAT-ee) is a major city in the U.S. state of Ohio, and is the government seat of Hamilton County. Settled in 1788, the city is located at the northern side of the confluence of the Licking and Ohio rivers, the latter of which marks the state line with Kentucky. The city drives the Cincinnati–Middletown–Wilmington combined statistical area, which had a population of 2,172,191 in the 2010 census making it Ohio's largest metropolitan area. With a population of 296,943, Cincinnati is the third-largest city in Ohio and 65th in the United States. Its metropolitan ar...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for PROVIDER NETWORK MANAGER jobs
$105,306 to $131,942
Cincinnati, Ohio area prices
were up 1.1% from a year ago
were up 1.1% from a year ago
What does a PROVIDER NETWORK MANAGER do?
PROVIDER NETWORK MANAGER in Lafayette, LA
NCQA Provider Network Accreditation creates a framework for organizations to provide efficient, accurate and consistent network management and credentialing services.
December 25, 2019
PROVIDER NETWORK MANAGER in Saginaw, MI
A crucial part of this effort is educating our providers about our plans, particularly our insurance benefits and workers’ compensation plans, and how to navigate the claims process for each one.
February 21, 2020
PROVIDER NETWORK MANAGER in Elkhart, IN
We offer providers a value-based reimbursement model centered on aligning quality measures, HEDIS measures and HH incentives to reward high-quality care of the members you serve.
January 03, 2020