Provider Network Manager & Contract Specialist

The Judge Group
Published
November 15, 2021
Location
Atlanta, GA
Category
Job Type

Description

Location: REMOTE
Description: Our client is currently seeking a Provider Network Manager & Contract Specialist

This is 100% remote opportunity. 

Responsibilities:

•         Review and track providers to confirm and validate participation in the Medicaid health plan network with a focus on meeting a day TAT goal.

•         Research and perform evaluation of provider and facility contracts.

•         Additionally, review claims and other provider documents to support a provider contract audit to validate participation in a Medicaid Network.

•         Candidate should understand provider contracts with health plans, understanding of provider types (Primary Care and specialist, facility, and ancillary provider).

•         Previous experience negotiating contract and/or provider contract configuration for a health plan will provide strong foundation of this work.

•         Attention to detail is required. Able to work based on production with high level of accountability for work completed per day (i.e., number of providers reviewed for the audit per day).

•         Strong computer skills including ability to navigate SharePoint and contract systems; intermediate level of proficiency with Microsoft Office Applications: Excel and Word. (MS Word- ability to create, edit, copy, send and save documents; MS Excel- create, edit and save spreadsheets)

Contact: [Click Here to Email Your Resumé]

This job and many more are available through The Judge Group. Find us on the web at www.judge.com
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