Provider Network Specialist jobs in Fort Lauderdale, FL

Provider Network Specialist 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. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Internal Provider Relations Representative
  • Health Network One
  • Fort Lauderdale, FL FULL_TIME
  • Health Network One is the leader in managing specialty healthcare networks. Founded in 1999, we are a rapid growing, private equity-backed company that delivers cost savings to our health plan customers, world-class service to our provider networks, and access to quality healthcare for health plan members.

    On behalf of our health plan clients, we manage the entire network value chain, including utilization management, claims, and provider management. Our specialty networks exceed 10,000 providers and include outpatient therapy, dermatology, podiatry and more. Today we operate in four states and are expanding into four more; in total, we cover more than 5,000,000 lives.

    Position Summary:

    Interacts with and discusses contract and credentialing with physicians, specialist, ancillary providers and hospitals. Performs revenue analyses for the Provider Relation/ Network Department.

    Essential Duties and Responsibilities

    • Target and/or follow-up with potential providers to establish contractual agreements.
    • Interacts with provides regarding all contract matters for HN1 including any necessary documentation. (i.e. credentialing, applications, W-9, PIP, etc)
    • Recruits and contracts physicians, specialists, ancillary providers and hospitals for HN1.
    • Responds to provider inquiries regarding contract matters, provider networks issues and HN1 operations.
    • Works with contracted providers to help integrate their services into the overall care delivery network.
    • Researches and solves any questions or concerns that providers, external provider representatives, Health Plans and other internal departments may have.
    • Analyzes, prepares, maintains and distributes various departmental reports, including specialized reports for providers or networks; HN1 quarterly provider bulletins; various presentations and custom reports requested by Senior Management.
    • Organize, develop and execute provider outreach projects.
    • Researches providers utilization data with reference to negotiating new rates and utilization performance of individual providers and the network.
    • Maintain lines of communications with all internal departments and with all participating providers in enlisting their assistance in referring potential providers in the Network.
    • Attend corporate and departmental meetings to assist with company projects and goals (i.e.
    • URAC, Executive Committee meetings, etc.)
    • Ensures compliance with and/or adheres to company HIPAA policies and procedures.
    • Ensures integrity of data entered into company systems and databases.
    • Manage the normal office activities for the Network Department to include but not limited to:
    • Maintains and updates physician files.
    • Supports Credentialing Department by assisting with the collection of physician credentials for re-credentialing purposes.
    • Evaluates claim data on recently contracted providers, ensuring contract is profitable for Company.

    Required Education and Experience

    • High School graduate or equivalent (GED); and previous health care experience.
    • Bilingual is required (Spanish/English)
    • Knowledge of physician office procedures.
    • Knowledge of medical terminology, CPT coding, billing procedures.
    • Strong Organizational skills.

    Job Type: Full-time

    Pay: From $18.00 per hour

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Paid time off
    • Vision insurance
    • Work from home

    Weekly day range:

    • Monday to Friday

    Work setting:

    • In-person

    Work Location: In person

  • 6 Days Ago

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Provider Operations Representative
  • South Florida Community Care Network Llc
  • Fort Lauderdale, FL FULL_TIME
  • **MUST BE WILLING TO PHYSICALLY WORK NEAR SUNRISE, FLORIDA, 33323** Position Summary: Responsible for both the negotiation of provider contracts and ongoing education to the provider network in assign...
  • Just Posted

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Learning Network Specialist
  • Pine Crest Preparatory School Inc
  • Fort Lauderdale, FL FULL_TIME
  • Purpose The Learning Network Specialist is responsible for meeting with students individually and in small groups to address students’ varying learning styles and needs and provide individualized acad...
  • 7 Days Ago

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Provider Relations Specialist
  • Medi-Trans Inc
  • Pompano Beach, FL FULL_TIME
  • About UsMTI America is a health solutions company located in sunny Fort Lauderdale. As a leader in the Worker's compensation industry, our team of dedicated professionals seamlessly coordinates and de...
  • 15 Days Ago

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Provider Support Specialist (HP)
  • Cano Health
  • Miramar, FL FULL_TIME
  • Provider Support Specialist (HP)Cano Health is a rapidly growing operator of healthcare centers specializing in Senior Care and Primary Care for all ages. We are a vibrant company culture founded on t...
  • 17 Days Ago

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Provider Enrollment Specialist (Hollywood Corporate)
  • DERMCARE MANAGEMENT LLC
  • HOLLYWOOD, FL OTHER
  • Job Details Job Location: 4000 HOLLYWOOD BLVD SUITE 215-S - HOLLYWOOD, FL Salary Range: Undisclosed Travel Percentage: Negligible Job Shift: Day Job Category: Admin - Clerical Description The Enrollme...
  • 14 Days Ago

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0 Provider Network Specialist jobs found in Fort Lauderdale, FL area

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Network Engineer
  • Cordis
  • Hialeah, FL
  • Overview: About Us: Cordis is an independent, customer-focused global provider of interventional cardiovascular medical ...
  • 3/28/2024 12:00:00 AM

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Network Engineer - IT - Florida
  • Isotropic Network
  • Fort Lauderdale, FL
  • **This is an onsite position and not remote** Mission Statement Connecting the Planet Isotropic Networks is a Global Pro...
  • 3/28/2024 12:00:00 AM

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Sr. Network Engineer
  • Kolter Solutions
  • Fort Lauderdale, FL
  • Kolter Solutions is seeking a Senior Network Engineer Location: Remote Job Description: This client-facing role offers a...
  • 3/28/2024 12:00:00 AM

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Sr. Network Engineer
  • AutoNation, Inc.
  • Fort Lauderdale, FL
  • AutoNation Headquarters Position Summary: A senior network engineer, able to perform independently, applying technical e...
  • 3/27/2024 12:00:00 AM

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Network Engineer
  • Contact Government Services, LLC
  • Hollywood, FL
  • Network Engineer Employment Type: Full Time, Experienced level Department: Information Technology CGS is seeking an expe...
  • 3/26/2024 12:00:00 AM

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Provider Network Specialist-Hearing
  • NationsBenefits, LLC
  • Fort Lauderdale, FL
  • At NationsBenefits, we are committed to helping health plan members achieve a better quality of life through supplementa...
  • 3/25/2024 12:00:00 AM

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Network Engineer
  • ASR Group/Domino Sugar
  • West Palm Beach, FL
  • Florida Crystals is a leading domestic sugar producer and North Americas first fully integrated cane sugar company, guid...
  • 3/25/2024 12:00:00 AM

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Network Engineer
  • Cambridge International Systems Inc
  • Miami, FL
  • When you join the Cambridge team, you are part of a skilled and talented global community that is united by a set of cor...
  • 3/25/2024 12:00:00 AM

Fort Lauderdale (/ˈlɔːdərdeɪl/) is a city in the U.S. state of Florida, 28 miles (45 km) north of Miami. It is the county seat of Broward County. As of the 2017[update] census, the city has an estimated population of 180,072. Fort Lauderdale is a principal city of the Miami metropolitan area, which was home to an estimated 6,158,824 people in 2017. The city is a popular tourist destination, with an average year-round temperature of 75.5 °F (24.2 °C) and 3,000 hours of sunshine per year. Greater Fort Lauderdale, encompassing all of Broward County, hosted 12 million visitors in 2012, including...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$57,119 to $85,419
Fort Lauderdale, Florida area prices
were up 2.9% from a year ago

Provider Network Specialist in Springfield, MO
As the liaison between provider and the health plan, candidates are tasked with ensuring improved revenue generated and patient quality score.
December 16, 2019
Provider Network Specialist in Stamford, CT
Previous experience in a network development, provider recruitment or provider contracting.
December 04, 2019
Provider Network Specialist in Fort Wayne, IN
In this position, employees will be expected to perform benefits analysis and create reports on provider performance to support the needs of the analysis found.
January 18, 2020