Provider Network Specialist jobs in Gainesville, 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)
Recently Added Provider Network Specialist jobs
PRN Nurse Practitioner/ Flex Provider in Ocala
- Matrix Medical Network
-
Ocala, FL
FULL_TIME
- Company DescriptionMATRIX MEDICAL NETWORK is dedicated to helping in the care of Medicare Advantage plan members. Our success comes as the result of our extraordinary people, years of experience, advanced technology and powerful information management capabilities. In partnership with health plans and medical service providers, we are establishing new standards in health care quality, efficiency and effectiveness.Job DescriptionFLEX PROVIDER POSITION SUMMARY: The Flex Provider (fP) provides clinical assessment and care to assigned patients including assessments of health plan members in their homes and in facilities. The responsibilities include: adult/geriatric assessment, medical history, physical exam, medication reconciliation, diagnosis, and health education. Additionally, patient education, communication to the PCP, follow-up facilitated with the PCP, and case management referrals may also be part of any assessment. Clear documentation according to Matrix Medical Network (MMN) guidelines and protocols is required. Flex Providers will use previously acquired skills, education, medical training and experience as a medical professional in performing assessments. In the performance of the assessments, patient safety and well‐being is of the highest priority. Flex Providers are expected to maintain MMN standards for quality and customer service. Accordingly, the assessments performed by Flex Provider will be performed in accordance with currently approved and generally accepted professional medical standards and with MMN policies and procedures. From time to time, MMN will provide to Flex Providers copies of those policies and procedures. Other clinical care services may be required within the NP scope of practice. FLEX PROVIDER RESPONSIBILITIES: • Performs in-depth health risk assessments on all assigned members in patient homes or facilities • Works collaboratively with physicians, case managers, social workers, family members, key care givers and any appropriate ancillary medical personnel as appropriate • Responsible for identifying overall quality improvement activities through assessing and planning health care which is individualized to the member and consistent with Matrix Medical Network policies and protocols • Reviews and interprets the medical and social history of members • Performs appropriate screening procedures for members • Interprets laboratory data, recommends appropriate follow-up, reconciles medications • Refers members to PCP, case management and disease management programs as necessary. • Maintains positive control of all PHI information • Works closely with others within Matrix to create an effective and productive schedule • Is compliant with Matrix training/education requirements, OSHA, State Board of Nursing and other regulatory programs; seeks guidance for compliance-related concerns and adheres to all applicable laws, regulations and Matrix Medical Network policies and procedures QualificationsFLEX PROVIDER REQUIREMENTS: Knowledge, Skills and Abilities: • Must be able to demonstrate computer skills, including use of e-mail and Microsoft office word and excel • Must be able to demonstrate effective written communication skills including but not limited to writing reports and correspondence • Must be able to demonstrate effective verbal communication skills, including but not limited to speaking effectively to members, providers, families and staff and listening to members, providers and families • Demonstrated ability to meet deadlines, and use time effectively and efficiently. Concentrates efforts on priorities • Demonstrated successful experience working in an environment of change. Effectively copes with change and uncertainty; responds and “shifts gears” comfortably • Is dedicated to meeting the expectations and requirements of both external and internal customers, acts with customers in mind • Demonstrated ability to establish and maintain effective relationships with customers, and gain their trust and respect • Uses logical methods to solve problems with effective solutions; looks beyond the obvious for solutions • Is action oriented and sees challenges as opportunities Baseline Clinical Knowledge • Proven ability to perform comprehensive, adult/geriatric physical exam • Demonstrated ability to identify, diagnose and document chronic disease in adults • Demonstrated ability to recognize conditions, characteristics, and behaviors that place seniors at risk • Proven ability to pursue feedback, continuing education and professional development • Ability to effectively reconcile medications • Demonstrated ability to identify and document the needs of clinically complex patients Pertinent Clinical Work Experience which is relevant to Matrix • Must have: Minimum 1 year clinical experience as a Nurse Practitioner in geriatric, adult or family practice setting plus 3 – 5 years relevant RN experience or 2 -3 years Nurse Practitioner experience in geriatric, adult or family practice. Education • Bachelor of Science in Nursing preferred • Master’s Degree required OR commensurate experience and satisfactory completion of NP licensure Licensure/Certifications • Current RN and NP licensure in state of practice • Board certification by AANP or ANCC, in Adult, Family Practice and Geriatrics or Adult-Gerontology Primary Care • Current CPR certification Travel Requirements: Travel required • Must meet company driving standards • Must have valid state driver license and be able to drive a car • Must meet company’s automobile liability insurance standards and provide proof of coverage • Must be able to travel by public transportation, and airplanes • Must be able to independently travel to assigned locations Physical and Psychological Demands: • Requires prolonged sitting • Requires bending, stooping, twisting, kneeling, crouching, crawling and/or stretching from seated or standing positions • Requires eye-hand coordination and manual dexterity sufficient to operate medical equipment, computer tablet, computer keyboard, telephone, copier, calculator and other office equipment • Requires close vision, peripheral vision, and ability to adjust visual focus, hearing and smelling • Must be able to communicate information via telephone or computer • Requires moderate to intense concentration due to complexity of the job • Must be able to lift and/or move up to 75 lbs. • Must be able to observe “Universal Precautions” for blood-borne pathogens and body fluids Additional InformationEqual Opportunity EmployerMatrix Medical Network does not discriminate in practices or employment opportunities on the basis of an individual's race, color, national or ethnic origin, religion, age, sex, gender, sexual orientation, marital status, veteran status, disability, or any other proscribed category set forth in federal or state regulations.The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of the position.
- 1 Month Ago
Network Support Specialist I
- Radiant Credit Union
-
Gainesville, FL
FULL_TIME
- Role: Primary responsibility to implement and maintain the network computing systems (PCs, peripherals, software, communications) to ensure they are operating efficiently and that computing standards ...
- 11 Days Ago
Loan Specialist
- Farm Credit Network
-
Ocala, FL
FULL_TIME
- It has never been a better time to join Farm Credit of Florida as we continue to grow! Be a part of the talented team of employees supporting our local branch offices. In this role, you will deliver a...
- 18 Days Ago
Investigation Specialist-Quality
- Wells Pharmacy Network
-
Ocala, FL
FULL_TIME
- Job Description The Investigation Specialist will work cross-functionally with 503A and 503B operations and perform investigations keeping holistic view in mind. The specialist is responsible for driv...
- 17 Days Ago
Client Service Representative
- Community Care Veterinary Specialist
-
Gainesville, FL
FULL_TIME
- ResponsibilitiesOur CSRs are the first touchpoint to client interactions and provide exceptional customer service during every step of a visit to CCVSThe CSR handles in person, email and telephone int...
- 20 Days Ago
Overnight Emergency Critical Care Technician (FT)
- Community Care Veterinary Specialist
-
Gainesville, FL
FULL_TIME
- Come find out more about us! https://www.ccvetspecialists.com/ We are seeking a Full-time Veterinary Technician to join our team. This person will be responsible for managing overnight care for patien...
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0 Provider Network Specialist jobs found in Gainesville, FL area
Travel Radiology Technician - $1,846 per week
- Hiring Now!
-
Gainesville, FL
- HealthTrust Workforce Solutions HCA is seeking a travel Radiology Technician for a travel job in Gainesville, Florida. J...
- 4/24/2024 12:00:00 AM
Local Contract Radiology Technician - $45-53 per hour
- Hiring Now!
-
Gainesville, FL
- HealthTrust Workforce Solutions HCA is seeking a local contract Radiology Technician for a local contract job in Gainesv...
- 4/24/2024 12:00:00 AM
Cardiologist Critical Care Intensivist - Clinical Assistant, Associate, Full Professor
- University of Florida
-
Gainesville, FL
- Classification Title: CLIN AST/ASO/FULL PROF Job Description: The Cardiovascular Center at the University of Florida, Co...
- 4/23/2024 12:00:00 AM
Process Controls Engineer
- Gainesville Area Chamber Of Co
-
Gainesville, FL
- Milliken & Company is a global manufacturing leaderwhose focus on materials science delivers tomorrows breakthroughs tod...
- 4/23/2024 12:00:00 AM
Sr. Network Presales Engineer - Gainesville
- Howard Technology Solutions
-
Gainesville, FL
- *This position requires you to travel to customer sites around the Florida territory. Must be currently located within F...
- 4/22/2024 12:00:00 AM
Sr. Network Presales Engineer - Orlando
- Howard Technology Solutions
-
Gainesville, FL
- *This position requires you to travel to customer sites around the Florida territory. Must be currently located within F...
- 4/22/2024 12:00:00 AM
Administrative Coordinator (Supporting Research)- Jupiter, FL
- University of Florida
-
Gainesville, FL
- Classification Title: Lab Admin Coordinator II Job Description: To varying degrees, Administrative Professionals under R...
- 4/22/2024 12:00:00 AM
IT Technician Level II
- Technogroup Inc
-
Gainesville, FL
- Job Description Job Description About Us: Founded in 1989, ComSys is a Managed Technology Services Provider (MTSP) that ...
- 4/20/2024 12:00:00 AM
About Gainesville, Florida
Gainesville is located at 29°39'55" North, 82°20'10" West (29.665245, −82.336097), which is roughly the same latitude as Houston, Texas. According to the United States Census Bureau, the city has a total area of 62.4 square miles (161.6 km2), of which 61.3 square miles (158.8 km2) is land and 1.1 square miles (2.8 km2) is water. The total area is 1.74% water.
Gainesville's tree canopy is both dense and species rich, including broadleaf evergreens, conifers, and deciduous species; the city has been recognized by the National Arbor Day Foundation every year since 1982 as a "Tree City, USA".
Gain...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$52,911 to $79,102
Gainesville, Florida area prices
were up 1.5% from a year ago
were up 1.5% from a year ago
What does a Provider Network Specialist do?
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