Top Provider Network Executive jobs in Jackson, MS
Top Provider Network Executive plans and directs all aspects of an organization's provider network function. Responsible for developing the network and negotiating and administering contracts. Being a Top Provider Network Executive oversees provider relations and monitors and directs all provider services. Requires a bachelor's degree. Additionally, Top Provider Network Executive typically reports to a top management. The Top Provider Network Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Provider Network Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Recently Added Top Provider Network Executive jobs
BlueAdvantage Network Provider Consultant
- Blue Cross & Blue Shield of Mississippi
-
Flowood, MS
FULL_TIME
- Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. Job Summary The BlueAdvantage Network Provider Consultant serves as a consultant and corporate liaison to BlueAdvantage Network Providers, including, but not limited to professional, facility, and allied providers. This role provides consultative services to the BlueAdvantage Network Provider community to ensure compliance with BlueAdvantage contracts and performance expectations. This includes sharing of Network Provider performance against BlueAdvantage requirements, Centers of Medicare and Medicaid Services (CMS) rules for STARS ratings and clinical improvement of patients to include HEDIS improvement and gaps in care closure. The BlueAdvantage Network Provider Consultant will also be responsible for ensuring Network Provider compliance to improve administrative and clinical efficiency/effectiveness to assist in providing the highest quality and most cost effective healthcare to BlueAdvantage Members. Job-Specific Requirements: · A Bachelor’s degree in Business Administration, Health Administration, or Nursing. · At least three (3) years of professional healthcare experience and must possess knowledge of member and provider contract benefits, clinical guidelines, medical policy and claims processing for designated line(s) of business, or possess equivalent healthcare related industry knowledge. · Medicare Advantage benefit plans experience. · Experience in working with healthcare providers on improvement in Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. · Experience with and knowledge of Medicare STARS program to measure health plan and healthcare provider performance. · Knowledge of the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk adjustment model. · Exhibits professional and positive demeanor with excellent communication. · Excellent verbal and written communication skills including exemplary presentation skills, development of correspondence, review and management of performance documents etc. · Ability to travel throughout the state to meet with BlueAdvantage Network Providers. · Demonstrated proficiency in Microsoft Office Suite, especially Excel, Word and PowerPoint. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers. At Blue Cross & Blue Shield of Mississippi, we work daily to help Mississippians find their personal answers to this question through health and wellness partnerships with quality healthcare providers, employer groups and community leaders across the state. Our goal is to help each person along their journey to a healthier life… their Blue Wellness Journey. Our health and wellness benefits are designed to support our members in understanding their health and in receiving the care they need at the right time and place, beginning with establishing a healthy relationship with a Primary Care Network Provider through an annual wellness visit at no out-of-pocket cost. We partner with our Network Providers to ensure the highest quality, evidence-based care is provided in each care setting from primary care to specialty care through our Primary Care Home, Blue Distinction Centers of Excellence and Maternity Care Quality initiatives. We partner with employer groups to make every workplace a healthy workplace by providing tools and information to help employees take ownership of their health and understand and make the most of their benefits, all while working to manage health and healthcare costs. We partner with community leaders and organizations to make healthy living resources available to all Mississippians through the work of the Blue Cross & Blue Shield of Mississippi Foundation, our support of the arts and culture and our Team Blue volunteers. These partnerships and our dedicated team of employees are making a difference every day, in our communities and in the lives of each person we reach. So, what does it mean to be healthy? The answer is about you, your health, your life… and all its possibilities. Live healthy. Live Blue.
- 1 Month Ago
Sr. Network Management Service Provider
- NovaLink Solutions
-
Jackson, MS
FULL_TIME
- Job DetailsJob Description: Required Experience Network Management ExpertiseProven experience in providing network management services, with a track record of successful client engagements.Demonstrate...
- 5 Days Ago
Account Executive
- Gannett | USA TODAY NETWORK
-
Jackson, MS
FULL_TIME
- Position Title: Account Executive Location: Jackson Work Environment: Hybrid The Account Executive role requires a highly personable, intelligent individual with the ability to lead sales efforts focu...
- 22 Days Ago
Office Cleaner
- Bailey Executive
-
Brandon, MS
PART_TIME
- About usBailey Executive Services is a janitorial service in Jackson, MS. We are professional, agile and our goal is to give great courteous service and have repeat business. .Our work environment inc...
- 1 Month Ago
Network Analyst
- Jackson Public Schools
-
Jackson, MS
FULL_TIME
- Network Analyst QUALIFICATIONS Bachelor's or associate’s degree in a relevant field such as computer science, information technology, or a related discipline is preferred. Work experience with end-use...
- 18 Days Ago
Network Administrator
- Linbar Solutions, Inc.
-
Jackson, MS
FULL_TIME
- NETWORK ADMINISTRATOR If you have interest in this position please send resume in word with contact number to barbensminger@linbarsolutions.com Our Client in Jackson, Ms is looking for a Network Admni...
- 19 Days Ago
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0 Top Provider Network Executive jobs found in Jackson, MS area
Office Manager
- Electrical Contractor
-
Jackson, MS
- Job Description Job Description A Jackson, MS construction subcontractor is seeking an experienced professional to super...
- 4/26/2024 12:00:00 AM
Sales Executive
- City Lifestyle
-
Madison, MS
- Join the City Lifestyle Team as a Sales Executive City Lifestyle, formerly known as Lifestyle Publications, has been a p...
- 4/25/2024 12:00:00 AM
Territory Account Executive
- ADP
-
Jackson, MS
- ADP is hiring a Sales Representative, Major Accounts. Are you ready to control your financial future with unlimited upsi...
- 4/23/2024 12:00:00 AM
Business Development Executive
- Fusion Growth Partners
-
Jackson, MS
- Job Description Job Description Job Title: Business Development Executive Job AD Business Development Executive Executiv...
- 4/23/2024 12:00:00 AM
Recruitment Officer
- Humanrightscolumbia
-
Jackson, MS
- FULL-TIME JOB VACANCYRECRUITMENT OFFICERHuman Resources DivisionNew York or Washington, DC PreferredApplication Deadline...
- 4/23/2024 12:00:00 AM
Inside sales Officer
- Eurofins Horti
-
Jackson, MS
- Eurofins Scientific is een internationaal life sciences bedrijf. Het netwerk van Eurofins bedrijven biedt haar klanten i...
- 4/23/2024 12:00:00 AM
Executive Support Specialist
- Phi Theta Kappa Honor Society International
-
Jackson, MS
- **TITLE: Executive Support Specialist** **REPORTS TO:** Chief of Staff **FLSA STATUS:** Exempt **WORK LOCATION:** PTK He...
- 4/22/2024 12:00:00 AM
Central Merchants Sales, Executive
- Sovereigns Capital
-
Jackson, MS
- Life at GrabAt Grab, every Grabber is guided by The Grab Way, which spells out our mission, how we believe we can achiev...
- 4/22/2024 12:00:00 AM
About Jackson, Mississippi
Jackson is located primarily in northeastern Hinds County, with small portions in Madison and Rankin counties. The Pearl River forms most of the eastern border of the city. A small portion of the city containing Tougaloo College lies in Madison County, bounded on the west by Interstate 220 and on the east by U.S. Route 51 and Interstate 55. An unconnected section of the city surrounds Jackson–Evers International Airport in Rankin County. In the 2010 census, only 622 of the city's residents lived in Madison County, and only 1 lived within the city limits in Rankin County. The city is bordered t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Top Provider Network Executive jobs
$351,935 to $651,706
Jackson, Mississippi area prices
were up 1.2% from a year ago
were up 1.2% from a year ago