Network Relations Manager (Oklahoma)
Core
Primary resource for high-profile providers to establish and maintain relationships, resolving complex issues regarding Medicaid policies, plan design, contracts, claims, and compensation.
Role type
Senior Network Relations Manager (Medicaid/Managed Care)
Builds
Positive provider relationships and operational support for network access and contract management
Domain
US Healthcare / Medicaid / Managed Care
Deliverable
client delivery
Required skills
Medicaid policy interpretation, contract negotiation, claims resolution, provider education, cross-functional collaboration, database management, credentialing support, agenda facilitation, cost initiative management
Preferred skills
Medical terminology (CPT, ICD-10), Medicaid regulatory standards knowledge, Microsoft Office proficiency
Responsibilities
Optimize interactions with assigned providers; monitor service capabilities and resolve escalated claims/contract issues; support operational activities including database management and credentialing; educate providers on compliance and plan design; facilitate external provider meetings; collaborate on large provider system implementations to manage cost drivers; provide guidance to less experienced team members
Seniority
Senior, hands-on IC
