Provider Network Director jobs in Greenville, SC
Provider Network Director directs and develops a healthcare provider network. Designs and administers policies and services that comply with all contractual and regulatory requirements. Being a Provider Network Director requires a bachelor's degree. Typically reports to top management. The Provider Network Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Provider Network Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added Provider Network Director jobs
PRN Nurse Practitioner/ Flex Provider
- Matrix Medical Network
-
Townville, SC
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
Director of Human Resources
- NETWORK CONTROLS
-
Greer, SC
FULL_TIME
- Description Position SummaryThe Director of Human Resources will direct & lead all aspects of human resources management, payroll, benefits, 401k plan administration, and play a strategic role in comp...
- 26 Days Ago
Network Engineer
- Naviga
-
Greenville, SC
FULL_TIME
- Our client is a managed IT Services leader partnering with businesses in planning, developing, and implementing enterprise-class technology services. Naviga has been retained to help identify a Senior...
- 17 Days Ago
Network Engineer
- Spero LLC
-
Greenville, SC
FULL_TIME
- Our growing organization is currently seeking an enthusiastic and customer-focused Network Engineer to join our team. This dual-role position will require the successful candidate to provide network s...
- 6 Days Ago
Network Engineer
- Spero LLC
-
Greenville, SC
FULL_TIME
- Our growing organization is currently seeking an enthusiastic and customer-focused Network Engineer to join our team. This dual-role position will require the successful candidate to provide network s...
- 6 Days Ago
Network Technician
- Anderson University, South Carolina
-
Anderson, SC
FULL_TIME
- Anderson University’s Department of Information Technology invites applications for a full-time/part-time position as Network Technician. Anderson University is an innovative, entrepreneurial, premier...
- 10 Days Ago
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0 Provider Network Director jobs found in Greenville, SC area
Youth Housing Coordinator (HUD)
- Pendleton Place
-
Greenville, SC
- Job Details Title Youth Housing Coordinator Reports to: Director of Community Youth Services Classification: Exempt Hour...
- 4/24/2024 12:00:00 AM
Summer Day Camp Counselor
- KE Camps
-
Greenville, SC
- KE Camps is the leading provider of summer camps for country clubs nationwide. We partner with over 230 private clubs al...
- 4/24/2024 12:00:00 AM
Controls Engineer (5-10 years)
- TMC USA SE
-
Greer, SC
- Job Title: Controls Engineer Years of Experience: 5-10 Years Location: Greer/Anderson, SC Job Type: Full time with benef...
- 4/24/2024 12:00:00 AM
Sr. Project Director - Data Center Construction
- Fluor
-
Greenville, SC
- At Fluor, we are proud to design and build projects and careers. This requires teams that are as unique as the projects ...
- 4/23/2024 12:00:00 AM
Condition Assessment Leader - Pipeline Assessment & Renewal - Specialized Solutions (US Hybrid)
- Black & Veatch
-
Greenville, SC
- **Condition Assessment Leader - Pipeline Assessment & Renewal - Specialized Solutions (US Hybrid)** Date: Apr 18, 2024 L...
- 4/23/2024 12:00:00 AM
NEW - PMHNP or Psych NP Needed - Interviewing Now!
- LifeSource, Inc.
-
Greenville, SC
- Job Description Job Description Hiring Now-PT Job- PMHNP or Psych NP/PA with Psych Experience in the Greenville, SC Area...
- 4/22/2024 12:00:00 AM
Youth Housing Coordinator (HUD)
- Pendleton Place
-
Greenville, SC
- Job Details Title: Youth Housing Coordinator Reports to: Director of Community Youth Services Classification: Exempt Hou...
- 4/21/2024 12:00:00 AM
Summer Day Camp Counselor
- KECamps
-
Greenville, SC
- KE Camps is the leading provider of summer camps for country clubs nationwide. We partner with over 230 private clubs al...
- 4/21/2024 12:00:00 AM
About Greenville, South Carolina
Greenville is located at 34°50′40″N 82°23′8″W / 34.84444°N 82.38556°W / 34.84444; -82.38556 (34.844313, −82.385428), roughly equidistant between Atlanta (145 miles [233 km] southwest), and Charlotte, North Carolina (100 miles [160 km] northeast). Columbia, the state capital, is 100 miles (160 km) to the southeast.
Greenville is in the foothills of the Blue Ridge Mountains, a physiographic province of the larger Appalachian Mountains range, and includes many small hills. Sassafras Mountain, the highest point in South Carolina, is in northern Pickens County, less than 40 miles (64 km) northwe...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$161,180 to $208,232
Greenville, South Carolina area prices
were up 1.5% from a year ago
were up 1.5% from a year ago
What does a Provider Network Director do?
Provider Network Director in Moline, IL
You can keep costs low when using your plan by staying “in network,” or using the doctors and other health care providers that are in your plan’s network.
December 27, 2019
Provider Network Director in Sacramento, CA
A healthcare provider network is a compilation of all doctors, physicians, hospitals, clinics, pharmacies, etc.
February 22, 2020
Provider Network Director in Springfield, OR
If the plan name includes any of the following things, your plan does NOT use the standard network.
February 12, 2020