Provider Network Director jobs in Pennsylvania
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
Provider Network Coordinator
- AmeriHealth Caritas
-
Philadelphia, PA
FULL_TIME
-
Your career starts now. We are looking for the next generation of healthcare leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
Responsible for addressing provider issues and maintaining the provider tracking databases. ;In addition, the Network Coordinator supports the Network Management Department by assisting with root cause analysis and the development of reports, as well as other support activities related to monitoring the accuracy of provider contract configuration and resolution of provider issues.- Serves as a resource to Network Management Account Executives for contracting and provider set-up questions/issues.
- Assists the Contract Management Coordinator as necessary to assess issues/problems providers and staff encounter.
- Responsible for Provider demographic management, including additions, deletions, corrections, and initial provider loads to Provider Maintenance.
- Responsible for tracking State inquiries related to Provider escalations.;
- Responsible for the LTSS Home and Community Based Service (HCBS) Add and Terms with the State, as mandated by the State.
- Responsible for updating the provider contract database with new information or modifications to existing provider contracts accurately and within established timeframes.
- Associate degree or equivalent combination of education and work experience in a health care field is;preferred.
- Minimum of 1 to 2 years experience in member, provider, and finance operations in a healthcare or Managed Care Organization.
- 1 to 2 years of customer service experience.
- 1 to 2 years of business analyst experience preferred.
- 1 to 2 years of Medicaid experience preferred.
- All Microsoft Office application, Facets, Navinet, HHA, and Promise systems.;;
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more. - 5 Days Ago
Provider Network Coordinator
- AmeriHealth Caritas Health Plan
-
Philadelphia, PA
FULL_TIME
- Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities....
- 12 Days Ago
Coordinator Provider Network
- AmeriHealth Caritas Health Plan
-
Philadelphia, PA
FULL_TIME
- Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities....
- 23 Days Ago
Advanced Practice Provider, Cardiology
- Allegheny Health Network
-
Erie, PA
FULL_TIME
- Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: The Advanced Practice Providers at Allegheny Health Network are an integral part of the care delivery system working together to ...
- 9 Days Ago
Advanced Practice Provider, Neurology
- Allegheny Health Network
-
Pittsburgh, PA
FULL_TIME
- Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: The Advanced Practice Providers at Allegheny Health Network are an integral part of the care delivery system working together to ...
- 2 Months Ago
VP Reimbursement, Provider & Network Programs
- Highmark Health
-
Pittsburgh, PA
FULL_TIME
- Company : Highmark Health Job Description : JOB SUMMARY This role is accountable for any program or strategic tactic to drive provider performance in the domains of reimbursement and network programs....
- 24 Days Ago
Provider Network Director jobs at Popular Companies
Director of Networking
- Insight Global
-
- Director of Network Services and Engineering Must be in Nashville, TN - Hybrid schedule of 3 days onsite Requirements: 1...
- 6/2/2024 12:00:00 AM
EXECUTIVE DIRECTOR OF NETWORK INFRASTRUCTURE & INTEGRITY
- City of New York
-
New York, NY
- Job Description APPLICANTS MUST BE PERMANENT IN THE COMPUTER SYSTEMS MANAGER CIVIL SERVICE TITLE. The Department of Soci...
- 6/2/2024 12:00:00 AM
Director of Network Support
- Communities In Schools North Carolina
-
Raleigh, NC
- About Communities in Schools of North Carolina: At Communities in Schools, we are all-in for kids. It is our passion-- i...
- 6/1/2024 12:00:00 AM
Junior Network Administrator
- MOI, Inc
-
Baltimore, MD
- Job Description Job Description Position: Jr. Network Administrator Dept: Technical Resources Reports to: IT Director of...
- 6/1/2024 12:00:00 AM
Director Local Network
- Idaho State Job Bank
-
Boise, ID
- Director Local Network at Lumen in Boise, Idaho, United States Job Description About Lumen Lumen connects the world. We ...
- 5/29/2024 12:00:00 AM
Network Director of School Operations
- Mastery Charter Schools
-
Philadelphia, PA
- About Mastery: Founded in 2001, Mastery Schools is a public charter network of 24 K-12 schools in Philadelphia and Camde...
- 5/29/2024 12:00:00 AM
Executive Assistant to the Director - Information Networking Institute
- Carnegie Mellon University
-
Pittsburgh, PA
- The Information Networking Institute (INI) at Carnegie Mellon University (CMU) educates and develops engineers through t...
- 5/29/2024 12:00:00 AM
Specialty Provider Network Representative
- ChenMed
-
Charlotte, NC
- We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you in...
- 5/29/2024 12:00:00 AM
About Pennsylvania
Pennsylvania (/ˌpɛnsɪlˈveɪniə/ (listen) PEN-sil-VAY-nee-ə), officially the Commonwealth of Pennsylvania, is a state located in the northeastern and Mid-Atlantic regions of the United States. The Appalachian Mountains run through its middle. The Commonwealth is bordered by Delaware to the southeast, Maryland to the south, West Virginia to the southwest, Ohio to the west, Lake Erie and the Canadian province of Ontario to the northwest, New York to the north, and New Jersey to the east.
Pennsylvania is the 33rd-largest state by area, and the 6th-most populous state according to the most recent of...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$173,542 to $224,201
Most Popular Cities in Pennsylvania for Provider Network Director Jobs
What does a Provider Network Director do?
Provider Network Director in Columbus, OH
In either scenario, taking these three steps can help you determine whether a network change will genuinely lower your costs.
February 09, 2020
Provider Network Director in Portland, ME
We offer providers a value-based reimbursement model centered on aligning quality measures, HEDIS measures and HH incentives to reward high-quality care of the members you serve.
December 12, 2019
Provider Network Director in Temple, TX
However, from a state regulator’s and the health plan’s perspective, the sheer number of providers in the network overall is only part of the story.
December 21, 2019