PROVIDER NETWORK MANAGER jobs in Clearwater, FL

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:

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