Community Medical Centers

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Provider Network Manager, Managed Care, Full-Time 8 Hour

at Community Medical Centers

Posted: 10/7/2019
Job Status: Full Time
Job Reference #: 12842

Job Description

  • Requisition ID
    2019-12842
    Category
    Professional
    Facility
    Community Medical Centers - Corporate Offices (CMC)
    Location
    US-CA-Fresno
    Posted Date
    10/21/2019
  • Responsibilities

    As a provider Network Manager you will work closely with the business office to manage contracts (e.g. physician and ancillary contracts) for our clients. You will also have the opportunity to serve as a mentor to our contract coordinators.

    Responsibilities Include:

    • Responsible for daily activities related to provider relations, credentialing, post-contract administration and provider education.
    • Assists management in network and contract management activities which occur after contract negotiation and in conjunction with contract implementation and ongoing contract compliance.
    • Facilitates contract management meetings with multi-disciplinary departments to monitor contract compliance and oversee problem resolution.
    • Accountable for the accurate maintenance and management of provider databases and for reporting activities required to ensure contractual and regulatory compliance.
    • Develops and implements procedures for contract administration in compliance with departmental policies to ensure contract and regulatory compliance and to address operational needs.
    • Mentors and works with Contract Coordinators providing expertise knowledge to accomplish goals and duties of the department.

    Qualifications

    EXPERIENCE AND EDUCATION:
    MINIMUM REQUIRED: Bachelor’s degree in Healthcare, Business Administration, or related field and three years’ experience in managed care, physician office or health plan environments. Seven years relevant experience may be substituted in lieu of education.

    PREFERRED: Master’s degree in Healthcare or Business Administration and four years’ experience in managed care, physician office or health plan environments.