Innova Solutions is immediately hiring for a Network Management Specialist
Position Type : Contract
Duration- 3-6 Months
Location- 100% remote
As a Network Management Specialist , you will :
- 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.
The ideal candidate will have :
- 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.
Thank you!
Mohit 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).
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