Network Manager


Location:

CHICAGO, IL

Date Posted:

May 22, 2019

Employment Type:

Permanent

Job Reference:

01300-0010617046

Staffing Area:

Technology & IT


Description
Seeking a Network Manager for a direct hire, permanent role. This position is responsible for the support, development and/or expansion of the US Domestic medical provider network by contracting medical facilities and ancillary providers, as well as managing network partners that are part of the networks’ platform.
• Strategizes, designs and implements network development plans with company objectives and goals.
• Manages key relationships with US Network partners including but not limited to: Carriers, Third Party Administrators and Leased Network organizations; ensuring that established Service Level Agreements (SLA’s) are met.
• Analyzes and leads the negotiations of contracted medical facilities and physicians.
• Manages and maintains existing provider relationships.
• Generates business by creating new relationships with physicians and other medical professionals, insurance companies, and other community-based referral sources.
• Work cross-functional with other members of Operations, Finance, I/T and other company teams
• Supports and troubleshoots provider network issues and questions.
• Disseminates medical network contract information throughout organization
• Investigates inquiries in a timely manner by answering remittance, payment, benefit, claims and eligibility questions when necessary.
• Coordinates with internal departments to support and troubleshoot provider network issues and questions.
• Creates reporting related to historical and current provider analysis, quarterly client reports, both international and domestic
• Manages and maintains the Other Billing Entity (OBE) database. Develops and leads provider outreach e-mail, and vendor ID form for OBE database.
• Works with IT to analyze historical data. Generate necessary queries to gather relevant information. Create monthly, quarterly and annual network development reports for internal and external clients.
• Leads various projects consisting of exporting, analyzing, proofreading data into comprehensive reports.
• Handle variety of additional projects as assigned relating to provider network operations.
Requirements
Insurance Brokerage, Health Care Audits - Medicare - Medicaid, PPO - Preferred Provider Organization

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Chicago, IL

205 N. Michigan Ave
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