PROVIDER NETWORK MANAGER jobs in Tallahassee, FL

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)

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Healthcare Network Development / Provider Relations Representative
  • Alivi
  • Tallahassee, FL FULL_TIME
  • SUMMARY
    The Network Development Representative focuses on building Specialty Benefits Networks across multiple Markets/States considering cost negotiations and adequacy to support expected membership volume by Levels of Service. The position will support the Specialty Benefits Networks with growth objectives and analytical analysis to ensure company strategies for expansion are adequate to meet contract demands for each respective Market/State. The position coordinates with Provider Leads to complete contracting with identified Specialty Benefit providers. 
    DUTIES & RESPONSIBILITIES
    • Target potential providers to establish contractual agreements.
    • Thoroughly understand Alivi’s Corporate Playbook and always ensure alignment with the     playbook in all day-to-day activities.
    • Work directly with strategic leaders of the company to ensure strategic support for expansion efforts and ability to administer contract arrangements with Health Plans/Payers in Medicare, Medicaid and Commercial lines of business. 
    • Travel to provider offices as needed to secure Specialty Benefit provider contracts.
    • Support Alivi’s business development, corporate growth strategy and goals as needed. 
    • Recruit, negotiate, contract and re-contract with Specialty Benefit providers at all ‘Levels of Service’ to ensure quality, cost effectiveness and their participation in all products.
    • Support contracting efforts for new products/risk strategies and help develop new service areas and negotiating with new providers.
    • Support in the development of strategic initiatives relating to provider networks, including service area expansions, new payment and incentive methods, risk arrangements and new products.
    • Work with provider relations team to develop and maintain a comprehensive provider network (hospitals, physicians, ancillary) that meets CMS access standards and deliver a full range of healthcare services to our members.
    • Analyze, plan, and assure provider network adequately meets all CMS access standards across all geographic areas.
    • Communicate internally and externally regarding all provider related issues. Participate in key committees throughout the organization.
    • Act as a liaison between Alivi and contracted health plans concerning all aspects of Specialty Benefit provider network participation. 
    • Supports Credentialing Department by assisting with the collection of physician credentials for newly contracted providers.
    REQUIREMENTS
    • Associates Degree preferred.
    • 1 to 2 years experience with Specialty Benefit providers and downstream provider contracting. 
    • Knowledge of provider reimbursement strategies for Managed Care, government products and commercial products.
    • Must have a valid driver’s license.    
    • Must be able to pass DMV record check.  
  • 16 Days Ago

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Project Manager-Network Infrastructure
  • Tech Army
  • Tallahassee, FL FULL_TIME
  • Job Title: Project Manager-Network InfrastructureLocation: Tallahassee, FL (Onsite)Duration: Long TermKnowledge, skills, and abilities:Candidate is responsible professional and technical work in direc...
  • 9 Days Ago

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Network Operations Manager
  • TECKpert
  • Tallahassee, FL FULL_TIME
  • We are looking for a Network Operations Manager to support our client based in Tallahassee, Florida.US BASED CANDIDATES ONLY. This is an on-site position. Candidates must be located in or near Tallaha...
  • 1 Month Ago

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Leasing Agent
  • H2 Property Manager
  • Tallahassee, FL PART_TIME,FULL_TIME
  • We are looking for capable Leasing Agent to perform all aspects of the leasing processes. From starting with the first initial interaction to turning them into happy tenants! We are looking for someon...
  • 1 Month Ago

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Account Manager - Orlando
  • SCALABLE Network Technologies
  • Tallahassee, FL FULL_TIME
  • Job Locations US-FL-Tallahassee Job Number 2024-14012 Category Sales Job Type Regular Open to Remote No Travel 25-50% Full Time / Part Time Full Time (F) Overview Keysight is on the forefront of techn...
  • 17 Days Ago

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Network Cabling Technician
  • Network Cabling Services, Inc.
  • Midway, FL FULL_TIME
  • Job Summary:We are seeking a skilled Cable Technician to join our team. As a Cable Technician, you will be responsible for installing, maintaining, and repairing various types of cable systems. This i...
  • 15 Days Ago

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0 PROVIDER NETWORK MANAGER jobs found in Tallahassee, FL area

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Senior Disaster Program Manager
  • Hagerty Consulting
  • Tallahassee, FL
  • Company Description Hagerty Consulting, Inc. (Hagerty) is the nation's leading emergency management and homeland securit...
  • 4/26/2024 12:00:00 AM

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Supervisory Tax Specialist (TCO Group Manager), NTE 1 YR (12 MONTH ROSTER) (Amended)
  • Department Of The Treasury
  • Tallahassee, FL
  • Duties WHAT IS THE TAX EXEMPT/GOVERNMENT ENTITIES (TEGE) DIVISION? A description of the business units can be found at: ...
  • 4/26/2024 12:00:00 AM

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GPRS Project Manager - Tallahassee, FL
  • GPRS
  • Tallahassee, FL
  • Job Details Job Location Tallahassee - Tallahassee, FL Position Type Full Time Education Level High School Diploma / GED...
  • 4/26/2024 12:00:00 AM

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Senior Project Manager - Cultural Resources Management
  • Kimley-Horn and Associates, Inc.
  • Tallahassee, FL
  • Overview Kimley-Horn has an opportunity for a motivated Senior Project Manager to expand our Cultural Resources Manageme...
  • 4/25/2024 12:00:00 AM

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Director, Program Management
  • Spruce Technology, Inc.
  • Tallahassee, FL
  • Primary Work: Lead Data & Analytics (D&A) strategy implementation for the Department to support D&A needs. Education: Ba...
  • 4/24/2024 12:00:00 AM

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Community Association Manager (on Site) - Palm Beach
  • Affinity Management Services Llc
  • Tallahassee, FL
  • Job TypeFull-timeDescriptionAffinity Management Services is an Association Management Company proudly serving Miami-Dade...
  • 4/24/2024 12:00:00 AM

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GOVERNMENT OPERATIONS CONSULTANT I (Complaints Coordinator) - 41500513 1
  • State of Florida
  • Tallahassee, FL
  • Requisition No: 827617 Agency: Florida Gaming Control Commission Working Title: GOVERNMENT OPERATIONS CONSULTANT I (Comp...
  • 4/24/2024 12:00:00 AM

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Executive Director (RN)
  • SunCrest OMNI
  • Tallahassee, FL
  • We are hiring for an Executive Director - RN with Home Health experience.  At SunCrest OMNI Tallahassee, a part of LHC G...
  • 4/24/2024 12:00:00 AM

Tallahassee (/ˌtæləˈhæsi/) is the capital city of the U.S. state of Florida. It is the county seat and only incorporated municipality in Leon County. Tallahassee became the capital of Florida, then the Florida Territory, in 1824. In 2017, the population was 191,049, making it the 7th-largest city in the U.S state of Florida, and the 126th-largest city in the United States. The population of the Tallahassee metropolitan area was 382,627 as of 2017[update]. Tallahassee is the largest city in the Florida Panhandle region, and the main center for trade and agriculture in the Florida Big Bend and S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for PROVIDER NETWORK MANAGER jobs
$97,015 to $121,554
Tallahassee, Florida area prices
were up 1.5% from a year ago

PROVIDER NETWORK MANAGER in Lafayette, LA
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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.
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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