Provider Network Specialist jobs in Albuquerque, NM

Department: Provider Network Development

FTE: 1.00
Full Time
Shift: Days

Position Summary:
Manage negotiation, operation, and administration of liaison activities associated with healthcare provider contracting for the TriWest Veteran Administration (VA) Community Care Network (CCN) for the state of New Mexico. Develop and deliver provider education for participant facilities and individual physicians, in compliance with CCN program requirements, and conduct research into claims, referral and authorization, and other operational issues related to provider contracting and networking. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.

Qualifications

Experience:
Essential:
3 years directly related experience

Nonessential:
No preferred experience

Physical Conditions:
Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.