- Assesses network needs, analyzes network composition, and using organization databases, application of regulatory requirements, accreditation entities and other resources, recruit's individual, group and/or organizational providers to meet network adequacy standards and assure quality network.
- Conducts and coordinates contracting and amendment initiatives. Provides issue resolution and complex trouble shooting for providers.
- Conducts provider education and provider relation activities, providing necessary written materials.
- Conducts administrative provider site visits and coordinates report development and completion according to contractual requirements or ad hoc requests.
- Coordinates Public Policy Research Center (PPRC) activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality-of-care issues and complaints against providers.
- Conducts and manages ongoing audits of provider compliance with Client's policies and procedures as well as contractual obligations for multiple customers.
- Develops work plans to address audit requirements. Works with management to draft, clarify and recommend changes to policies which impact network management.
- Knowledge of National Committee for Quality Assurance (NCQA) requirements.
- Intermediate knowledge of Microsoft Office Suite, specifically Excel.
- Strong presentations skills using PowerPoint. Minimum of 1 year experience in related position/field.
- Previous experience in a network development, provider recruitment or provider contracting.
- One of Largest IT Consulting Staffing firms in the USA - Recognized as #4 by Staffing Industry Analysts (SIA 2022)
- ClearlyRated Client Diamond Award Winner (2020)
- One of the Largest Certified MBE Companies in the NMSDC Network (2022)
- Advanced Tier Services partner with AWS and Gold with MS
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Network Management Specialist - Clayton, MO, United States - Innova Solutions
Description
Innova Solutions is immediately hiring for a Network Management Specialist
Position Type: Contract
Duration- 3-6 Months
Location- 100% remote
The ideal candidate will have:
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.
Thank youMohit Vyas
Sr. Associate ? Recruitment
PAY RANGE AND BENEFITS:
Pay Range*: $27-$29.93 per hour.
*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc. Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP). ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields. Recent Recognitions:
Website :
Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at or. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b. The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.
American Cybersystems, Inc is acting as an Employment Business in relation to this vacancy.
