Provider Network Director jobs in Colorado
Provider Network Director directs and develops a healthcare provider network. Designs and administers policies and services that comply with all contractual and regulatory requirements. Being a Provider Network Director requires a bachelor's degree. Typically reports to top management. The Provider Network Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Provider Network Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added Provider Network Director jobs
Senior Provider Network Contractor
- Colorado Access
-
Aurora, CO
CONTRACTOR
- Why should you consider a career with Colorado Access? We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP ) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion. Find work/life balance: We offer PTO, floating holidays, seven company paid holidays, work from home options (exceptions apply), an Employee Assistance Program and a 401K. Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference. Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend. What you will do: We are looking for a Senior Provider Network Contractor who can help shape our vision and support our mission. Here is what the position will look like. Negotiates complex provider agreements utilizing a variety of negotiation strategies and techniques with all provider types, with emphasis on developing strategic partnerships with facilities, health systems, integrated care delivery systems, physician hospital organizations, independent practice associations, individual providers and clinics, ancillary providers, FQHCs and other providers. . Maintains proficiency in current and proposed reimbursement methodologies for facility and professional contracts, contract language and provisions and organizational operations to assure contract offers can be implemented and effectively administered. Provides comprehensive management of the contracting process, including rate and language negotiations, and operational implementation. Works with contracted providers on contract interpretation and assists with operational and/or reimbursement issue resolution. Serves as the project lead and subject matter expert for one or more of the following: Development and revision of multiple contract templates for contract management system, in collaboration with the Director, and software vendor Fee schedule analysis Appropriate billing and coding for physical and behavioral health Serves as contract management system administrator as assigned Works with legal and other staff to resolve complex claims issues Provides financial and operational performance analysis of existing and pending Provider contracts. Provides guidance, support and direction to Managed Care Contractors and other department staff as needed. Participates in Lines of Business financial operational meetings as assigned by Director. What you will bring: Education: Bachelor’s degree in health administration, business administration or related field required with a Masters’ degree preferred. Any combination of education or experience may be substituted for education or experience. Experience: Five to eight years’ experience negotiating complex contracts with health care providers (e.g., hospitals, health systems, medical groups, clinics). Experience with strategic planning; development, revision and quality control of contract templates, contracting guidelines; determination of network adequacy and capacity standards and other policies and procedures Knowledge, Skills, and Abilities: Working knowledge of the various medical reimbursement platforms including the Resource Based Relative Value System, Diagnostic Related Groups, and Medicaid reimbursement required. Demonstrates support for the company’s mission, vision and values. Must have excellent negotiation skills and techniques and knowledge of current negotiation strategies. Position requires excellent written, verbal and public speaking communication skills. Requires training, project development and management skills. Advanced knowledge of managed care contracting, provider reimbursement and claims payment, medical terminology, and health care delivery systems required. Knowledge of local health and community agencies and providers preferred. Strong attention to detail with ability to handle multiple tasks simultaneously required. Ability to deal with multiple levels of staff. Must be able to handle high volume workload. Ability to work independently with little direction and initiate work priorities. Must be proficient in MS-Office applications (Word, Excel, and Access). May be required to manage multiple priorities and projects with tight deadlines. Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving. Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization. Pay, Perks and Benefits at Colorado Access: The compensation for this position is $90,180.00 - $108,220.00 annually. The pay rate/salary is commensurate with experience. In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes: Medical, dental, vision insurance that starts the first day of the month following start date. Supplemental insurance such as critical illness and accidental injury. Health care and dependent care flexible spending account options. Employer-paid basic life insurance and AD&D (employee, spouse and dependent). Short-term and long-term disability coverage. Voluntary life insurance (employee, spouse, dependent). Paid time off Retirement plan Tuition reimbursement (based on eligibility). Annual bonus program (based on eligibility, requirements and performance). Where you will work: This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’ We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.
- 30 Days Ago
Director, Provider Integration (CIN)
- Children's Hospital Colorado
-
Aurora, CO
FULL_TIME
- Why Work at Children's....Here, it’s different. Come join us.Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years. Here, the nation’s brightes...
- 1 Day Ago
Director, Provider Integration
- Children's Hospital Colorado
-
Aurora, CO
FULL_TIME
- Apply for JobJob ID86916 LocationAurora, Colorado Full/Part TimeFull-Time Regular/TemporaryRegular Add to Favorite Jobs Why Work at Children's.... Here, it's different. Come join us.Children's Hospita...
- 18 Days Ago
Director, Network Engineering (Remote)
- Vero Networks
-
Denver, CO
FULL_TIME
- The Director, Network Engineering will plan, architect, and manage all activities in the Engineering department, ensuring the development and implementation of efficient operations and cost-effective ...
- 6 Days Ago
Executive Director-East Network
- Boulder Valley School District
-
Boulder, CO
FULL_TIME
- Job DescriptionBoulder Valley School District is committed to create challenging, meaningful, and engaging learning opportunities so that all children thrive and are prepared for successful, civically...
- 6 Days Ago
Director, Network Engineering
- DISH
-
Littleton, CO
FULL_TIME
- Company Summary: DISH, an EchoStar Company, has been reimagining the future of connectivity for more than 40 years. Our business reach spans satellite television service, live-streaming and on-demand ...
- 22 Days Ago
Provider Network Director jobs at Popular Companies
AmeriCorps Math Tutor - Chicago
- Saga Education
-
Chicago, IL
- Employment status/hours: In-Person; Full-time; Monday – Friday (during traditional school hours) Application period: Ope...
- 6/11/2024 12:00:00 AM
Outreach and Donations Coordinator
- I Support The Girls
-
Rockville, MD
- Office Location: Rockville, MD Schedule: Full-time, Monday-Friday (8:30am EST-5:30pm EST) Who we are: Through an interna...
- 6/11/2024 12:00:00 AM
Physical Therapist
- Evidence Physical Therapy
-
Glenn Dale, MD
- About us Evidence Physical Therapy is a Physical Therapist owned outpatient practice with clinics in Glenn Dale(Bowie), ...
- 6/11/2024 12:00:00 AM
Senior Director Global Marketing
- Truly
-
- About the Brand: Truly Beauty is a leading beauty company built around its award-winning and iconic bath & beauty produc...
- 6/11/2024 12:00:00 AM
Co-Executive Director (California Environmental Justice Alliance)
- Nonprofit HR
-
Oakland, CA
- Co-Executive Director – Programs Co-Executive Director – Development & Operations About the Organization The California ...
- 6/11/2024 12:00:00 AM
Physical Therapist
- Therapeutic Associates Physical Therapy
-
Springfield, OR
- Therapeutic Associates Inc. - Creswell PT and Gateway PT (Springfield) are currently seeking to fill full and part-time ...
- 6/11/2024 12:00:00 AM
Business Development Manager
- Bogart Wealth
-
McLean, VA
- Long-term growth leads to business success — and here at Bogart Wealth, we welcome prospective team members who can help...
- 6/11/2024 12:00:00 AM
2024-25 Elementary Lead Teacher
- Public Preparatory Network
-
New York, NY
- An Invitation to Apply for the Position of Elementary Lead Teacher (Available 2024-2025) Girls Prep Bronx Elementary Sch...
- 6/11/2024 12:00:00 AM
About Colorado
Colorado (/ˌkɒləˈrædoʊ, -ˈrɑːdoʊ/ (listen), other variants) is a state of the Western United States encompassing most of the southern Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains. It is the 8th most extensive and 21st most populous U.S. state. The estimated population of Colorado was 5,695,564 on July 1, 2018, an increase of 13.25% since the 2010 United States Census.
The state was named for the Colorado River, which early Spanish explorers named the Río Colorado for the ruddy silt the river carried from the mountains. The...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$177,760 to $229,657
Most Popular Cities in Colorado for Provider Network Director Jobs
What does a Provider Network Director do?
Provider Network Director in Columbus, OH
In either scenario, taking these three steps can help you determine whether a network change will genuinely lower your costs.
February 09, 2020
Provider Network Director in Portland, ME
We offer providers a value-based reimbursement model centered on aligning quality measures, HEDIS measures and HH incentives to reward high-quality care of the members you serve.
December 12, 2019
Provider Network Director in Temple, TX
However, from a state regulator’s and the health plan’s perspective, the sheer number of providers in the network overall is only part of the story.
December 21, 2019