Provider Network Administrator


Ascension


Posted Under: Nashville, Tennessee jobs in IT / Software / Systems; IT / Software / Systems jobs in zipcode 37250
Posted On: 2019-01-12

We Are Hiring

Provider Network Administrator - Full-Time, Days - 523 Mainstream Dr - Nashville, TN

Why Join Employer?

Employer Care Management (ACM) creates customized healthcare solutions for health systems, payers, and employers that stabilize costs, improve outcomes, and enhance the experience for both providers and individuals. Our range of services strive to create a seamless healthcare experience for providers, payers and healthcare leaders by improving access to and removing complexity from the delivery of healthcare.

ACM serves 1.3 million patients across the nation and manages more than 20,000 providers through our clinically integrated networks of providers. ACM helps our customers eliminate stress and uncertainty, allowing them to confidently provide quality, value-based services and solutions. Beyond traditional population health management solutions, ACM offers additional expertise in claims management, care coordination, risk management and safety strategies that allow healthcare leaders to avoid challenges and capitalize on healthcare opportunities.

What You Will Do

As a Provider Network Administrator with Employer, you will have the opportunity to direct physician network operations management to include contract negotiation strategies, contract implementation and the monitoring of the managed care and other third party contracts for the physician network.

Responsibilities:

  • Plans and implements strategies for the negotiation and maintenance of competitive provider contracts, including Preferred Provider Organization (PPO), EPO, Health Maintenance Organization (HMO), and Workers Compensation.
  • Ensures compliance with the terms of the contracts and provides reports regarding the performance of the managed care companies/contracts.
  • Markets the network to new physicians, insurance companies, third party payors, and other payers/purchasers.
  • Recommends new and revised operating policies for the physician network and ensures that they are uniformly communicated and implemented.

    What You Will Need

    Education:

    • Bachelor's Level Degree.

      Work Experience:

      • Five (5) years of related experience is required, to include management experience and contract negotiation and administration or experience in multi-specialty practice management.

        Equal Employment Opportunity

        Employer Health is an EEO/AA employer: M/F/Disabled/Vet. For further information regarding your EEO rights, click on the following link to the "EEO is the Law" poster:http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf" Please note that Employer will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Employer will not solicit money or banking information from applicants.
        E-Verify Statement

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        E-Verify (link to E-verify site)

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