PROVIDER NETWORK MANAGER jobs in Massachusetts

PROVIDER NETWORK MANAGER manages the operations of a healthcare provider network. Responsible for establishing and maintaining processes and systems to provide routine services to members including contract management and credentialing. Being a PROVIDER NETWORK MANAGER recruits, hires, trains, and measures performance of staff to provide effective and operations within budget. May be involved with the design and operations of database systems used to manage provider data and produce reports and analysis. Additionally, PROVIDER NETWORK MANAGER requires a bachelor's degree. Typically reports to top management. The PROVIDER NETWORK MANAGER typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a PROVIDER NETWORK MANAGER typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Provider Network Manager Sr
  • Elevance Health
  • Woburn, MA FULL_TIME
  • Location: NH-Manchester, MA-Boston, MA-Woburn, MA-Newton, CT-Rocky Hill

    Job Description Summary

    Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized.

    How You Will Make An Impact

    • Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
    • Works independently and requires high level of judgment and discretion.
    • May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
    • May collaborate with sales team in making presentations to employer groups.
    • Serves as a communication link between professional providers and the company.
    • Ensure that network composition includes an appropriate distribution of provider specialties.
    • Conducts more complex negotiations and drafts documents.
    • Prepare financial projections and conduct analysis.

    Minimum Requirements

    • Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
    • Experience in fee schedule development using actuarial models strongly preferred.
    • Travels to worksite and other locations as necessary.
  • 8 Days Ago

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Manager MA/RI Network Quality and CCA Provider and Facility Quality & Safety
  • Commonwealth Care Alliance
  • Boston, MA FULL_TIME
  • Why This Role is Important to Us: Reporting to the Sr Director, Quality Performance and Value Based Care, the Provider and Facility Quality & Safety Manager is responsible for designing and executing ...
  • 1 Month Ago

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Director, Network & Provider Analytics
  • Point32Health
  • Canton, MA FULL_TIME
  • Who We ArePoint32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building ...
  • 2 Days Ago

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Behavioral Health Advanced Practice Provider (NP/PA)
  • Transformations Care Network
  • Marlborough, MA FULL_TIME
  • Join us at Northeast Health Services, a member of Transformations Care Network (TCN), as we embark on an exciting journey to empower Advanced Practice Providers like you in making a difference. We are...
  • 2 Days Ago

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Behavioral Health Advanced Practice Provider (NP/PA)
  • Transformations Care Network
  • Danvers, MA FULL_TIME
  • Join us at Northeast Health Services, a member of Transformations Care Network (TCN), as we embark on an exciting journey to empower Behavioral Health Advanced Practice Providers (NP/PA) like you to m...
  • 6 Days Ago

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Behavioral Health Advanced Practice Provider (NP/PA)
  • Transformations Care Network
  • Dedham, MA FULL_TIME
  • Join us at Northeast Health Services, a member of Transformations Care Network (TCN), as we embark on an exciting journey to empower Behavioral Health Advanced Practice Providers (NP/PA) like you to m...
  • 6 Days Ago

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Dental Provider Network Manager (Client Relations Healthcare/Dental)
  • LIBERTY Dental Plan
  • Building Brighter Futures, One Smile at a Time! LIBERTY Dental Plan is seeking an experienced Dental Provider Network Ma...
  • 6/12/2024 12:00:00 AM

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Manager Provider Network Management
  • AmeriHealth Caritas
  • Palm Beach Gardens, FL
  • Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re pass...
  • 6/11/2024 12:00:00 AM

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Sr. Provider Network Manager
  • Blue Cross Blue Shield of Arizona
  • Phoenix, AZ
  • Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make ...
  • 6/10/2024 12:00:00 AM

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Provider Network Manager Sr
  • Elevance Health
  • Manchester, NH
  • Anticipated End Date: 2024-07-31 Position Title: Provider Network Manager Sr Job Description: Location: NH-Manchester, M...
  • 6/10/2024 12:00:00 AM

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Service Provider Manager (SPM) (Referral Management Clerk) - Eglin AFB, FL
  • Reef Systems
  • Eglin Afb, FL
  • Service Provider Manager (SPM) (Referral Management Clerk) - Eglin AFB, FL Background/Experience : Shall read, understan...
  • 6/10/2024 12:00:00 AM

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Director of Provider Engagement
  • Tandym Group
  • New York, NY
  • A health services organization in New York City is currently seeking an experienced professional to join their staff as ...
  • 6/10/2024 12:00:00 AM

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Strategic Account Executive
  • Virsys12
  • Strategic Sales Account Executive, Salesforce.com and Healthcare Consulting Practice and SAAS Software V12 Network Virsy...
  • 6/10/2024 12:00:00 AM

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Provider Network Manager
  • Devoted Health
  • Cincinnati, OH
  • At Devoted Health, we're on a mission to dramatically improve the health and well-being of older Americans by caring for...
  • 6/8/2024 12:00:00 AM

Massachusetts is the 7th-smallest state in the United States. It is located in the New England region of the northeastern United States and has an area of 10,555 square miles (27,340 km2), 25.7% of which is water. Several large bays distinctly shape its coast. Boston is the largest city, at the inmost point of Massachusetts Bay, and the mouth of the Charles River. Despite its small size, Massachusetts features numerous topographically distinctive regions. The large coastal plain of the Atlantic Ocean in the eastern section of the state contains Greater Boston, along with most of the state's po...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for PROVIDER NETWORK MANAGER jobs
$117,693 to $147,462

PROVIDER NETWORK MANAGER in Tucson, AZ
There are different Location Providers, which one is the most accurate? The GPS Provider or the Network Provider.
January 08, 2020
PROVIDER NETWORK MANAGER in Saint Louis, MO
Healthcare providers are continually struggling with the increasing pressure to cut down on patient costing, providing higher quality service, increased accessibility, etc.
January 10, 2020
PROVIDER NETWORK MANAGER in Norfolk, VA
5+ years of experience in a network management-related role, such as contracting or provider services.
February 05, 2020