Network Management Specialist
Core
Develops and maintains the physician, practitioner, group, and facility services delivery system for small to mid-size markets, ensuring network adequacy and quality.
Role type
Network Management Specialist
Builds
Provider network services delivery system
Domain
Healthcare administration / Insurance
Deliverable
product features
Required skills
Network composition analysis, provider recruitment, contracting management, issue resolution, provider education, audit management, policy drafting
Preferred skills
NCQA requirements knowledge, independent work, prioritization, Microsoft Excel, PowerPoint
Technologies
Microsoft Office Suite (Excel, PowerPoint)
Responsibilities
Recruit providers to meet network adequacy standards; conduct contracting and amendment initiatives; resolve complex provider issues; manage provider compliance audits; coordinate public policy research center activities for credentialing and quality evaluation; draft and recommend policy changes.
Seniority
Entry-level to Mid-level, hands-on IC