Top Provider Network Executive jobs in Mississippi
Top Provider Network Executive plans and directs all aspects of an organization's provider network function. Responsible for developing the network and negotiating and administering contracts. Being a Top Provider Network Executive oversees provider relations and monitors and directs all provider services. Requires a bachelor's degree. Additionally, Top Provider Network Executive typically reports to a top management. The Top Provider Network Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Provider Network Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Recently Added Top Provider Network Executive jobs
BlueAdvantage Network Provider Consultant
- Blue Cross & Blue Shield of Mississippi
-
Flowood, MS
FULL_TIME
- Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. Job Summary The BlueAdvantage Network Provider Consultant serves as a consultant and corporate liaison to BlueAdvantage Network Providers, including, but not limited to professional, facility, and allied providers. This role provides consultative services to the BlueAdvantage Network Provider community to ensure compliance with BlueAdvantage contracts and performance expectations. This includes sharing of Network Provider performance against BlueAdvantage requirements, Centers of Medicare and Medicaid Services (CMS) rules for STARS ratings and clinical improvement of patients to include HEDIS improvement and gaps in care closure. The BlueAdvantage Network Provider Consultant will also be responsible for ensuring Network Provider compliance to improve administrative and clinical efficiency/effectiveness to assist in providing the highest quality and most cost effective healthcare to BlueAdvantage Members. Job-Specific Requirements: · A Bachelor’s degree in Business Administration, Health Administration, or Nursing. · At least three (3) years of professional healthcare experience and must possess knowledge of member and provider contract benefits, clinical guidelines, medical policy and claims processing for designated line(s) of business, or possess equivalent healthcare related industry knowledge. · Medicare Advantage benefit plans experience. · Experience in working with healthcare providers on improvement in Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. · Experience with and knowledge of Medicare STARS program to measure health plan and healthcare provider performance. · Knowledge of the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk adjustment model. · Exhibits professional and positive demeanor with excellent communication. · Excellent verbal and written communication skills including exemplary presentation skills, development of correspondence, review and management of performance documents etc. · Ability to travel throughout the state to meet with BlueAdvantage Network Providers. · Demonstrated proficiency in Microsoft Office Suite, especially Excel, Word and PowerPoint. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers. At Blue Cross & Blue Shield of Mississippi, we work daily to help Mississippians find their personal answers to this question through health and wellness partnerships with quality healthcare providers, employer groups and community leaders across the state. Our goal is to help each person along their journey to a healthier life… their Blue Wellness Journey. Our health and wellness benefits are designed to support our members in understanding their health and in receiving the care they need at the right time and place, beginning with establishing a healthy relationship with a Primary Care Network Provider through an annual wellness visit at no out-of-pocket cost. We partner with our Network Providers to ensure the highest quality, evidence-based care is provided in each care setting from primary care to specialty care through our Primary Care Home, Blue Distinction Centers of Excellence and Maternity Care Quality initiatives. We partner with employer groups to make every workplace a healthy workplace by providing tools and information to help employees take ownership of their health and understand and make the most of their benefits, all while working to manage health and healthcare costs. We partner with community leaders and organizations to make healthy living resources available to all Mississippians through the work of the Blue Cross & Blue Shield of Mississippi Foundation, our support of the arts and culture and our Team Blue volunteers. These partnerships and our dedicated team of employees are making a difference every day, in our communities and in the lives of each person we reach. So, what does it mean to be healthy? The answer is about you, your health, your life… and all its possibilities. Live healthy. Live Blue.
- 19 Days Ago
Provider Network Support Specialist I
- Centene Management Company LLC
-
Remote, MS
FULL_TIME
- You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll hav...
- Just Posted
Caregiver
- The Goode Provider
-
Southaven, MS
FULL_TIME
- Responsible for administrative as well as clinical tasks, such as maintaining patient records, preparing patients and rooms for examination, assisting providers with exams, and performing front-desk t...
- 30 Days Ago
Pulmonary Sales Consultant - Diagnostics/Lab
- Top Tier Reps
-
Sarah, MS
FULL_TIME
- Job Title: Pulmonary Sales Consultant - Diagnostics/LabLocation: Memphis, TN (Remote) - candidates must be in a 30 - 45 minute drive.Salary:$120 K base $20K sign-on uncapped comm. OTE just under $200K...
- 9 Days Ago
New york
- TOP Employee Travel Nursing
-
Jackson, MS
FULL_TIME
- Are You a Certified Nurse Aide (CNA)? We have opportunities for travel CNA's in multiple states - excellent pay rates and opportunity for overtime, advancement, and more!! Enjoy the job security and c...
- 1 Day Ago
Office Cleaner
- Bailey Executive
-
Brandon, MS
PART_TIME
- About usBailey Executive Services is a janitorial service in Jackson, MS. We are professional, agile and our goal is to give great courteous service and have repeat business. .Our work environment inc...
- 18 Days Ago
Top Provider Network Executive jobs at Popular Companies
Sales Executive - Employee Benefits
- AssuredPartners
-
- Overview Love what you do but not where you do it? As a Sales Executive at AssuredPartners, you will use your existing s...
- 6/11/2024 12:00:00 AM
Account Executive - Employee Benefits
- Marsh McLennan Agency
-
Aliso Viejo, CA
- Client Service Executive Summary Responsible for retention of existing business and the development of business within t...
- 6/10/2024 12:00:00 AM
Account Executive - Employee Benefits (26725)
- Dahl Consulting
-
Salem, OR
- Dahl Consulting is currently partnering with a leader in the insurance industry. We work one-on-one with great candidate...
- 6/10/2024 12:00:00 AM
Account Executive, Employee Benefits
- HUB International
-
Wichita, KS
- Primary Role: The Employee Benefits Account Executive is expected to contribute to the retention and growth of the emplo...
- 6/9/2024 12:00:00 AM
Account Executive - Employee Health and Benefits
- Marsh McLennan Agency
-
Dallas, TX
- ESSENTIAL DUTIES & RESPONSIBILITIES: Primary Contact with the Producer Manage the Client Insurance Program, utilizing ag...
- 6/9/2024 12:00:00 AM
Insurance Sales Executive - Employee Benefits
- AAA Club Alliance, Inc.
-
Maumee, OH
- Dedicated Account Management Team to service your book, so you can focus on selling Ability to quote through multiple ca...
- 6/8/2024 12:00:00 AM
Account Executive-Employee Benefits
- National Financial Partners Corp.
-
Palm Beach Gardens, FL
- Who We Are NFP is a seven-time Best Places to Work award winner in Business Insurance who has also earned the 5-Star Div...
- 6/7/2024 12:00:00 AM
Senior Account Executive - Employee Benefits
- Confidential
-
Alpharetta, GA
- SUMMARY: Retain clients through servicing and management of client relationships both internally and externally. Collabo...
- 6/7/2024 12:00:00 AM
About Mississippi
Mississippi is bordered to the north by Tennessee, to the east by Alabama, to the south by Louisiana and a narrow coast on the Gulf of Mexico; and to the west, across the Mississippi River, by Louisiana and Arkansas.
In addition to its namesake, major rivers in Mississippi include the Big Black River, the Pearl River, the Yazoo River, the Pascagoula River, and the Tombigbee River. Major lakes include Ross Barnett Reservoir, Arkabutla Lake, Sardis Lake, and Grenada Lake with the largest lake being Sardis Lake.
Mississippi is entirely composed of lowlands, the highest point being Woodall Mountai...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Top Provider Network Executive jobs
$354,755 to $656,931