Provider Network Specialist jobs in West Virginia
Provider Network Specialist coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Provider Network Specialist jobs
Provider Network Manager Sr
- The Elevance Health Companies, Inc.
-
CHARLESTON, WV
FULL_TIME
- Anticipated End Date: 2024-09-30 Position Title: Provider Network Manager Sr Job Description: Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized. How will you make an impact: Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development. Works independently and requires high level of judgment and discretion. May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management. May collaborate with sales team in making presentations to employer groups. Serves as a communication link between professional providers and the company. Ensure that network composition includes an appropriate distribution of provider specialties. Conducts more complex negotiations and drafts documents. Prepare financial projections and conduct analysis. Minimum Requirements: Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background. Experience in fee schedule development using actuarial models strongly preferred. May require travel up to 30%. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: PND > Network Contracting Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
- 3 Days Ago
Provider Network Manager Sr
- Elevance Health
-
CHARLESTON, WV
FULL_TIME
- Description Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically wo...
- 5 Days Ago
Behavioral Health Advanced Practice Provider (NP/PA)
- Transformations Care Network
-
Charleston, WV
FULL_TIME
- Join us at Harmony, a member of Transformations Care Network (TCN), as we embark on an exciting journey to empower Behavioral Health Advanced Practice Providers (NP/PA) like you to make a difference i...
- 4 Days Ago
Behavioral Health Advanced Practice Provider (NP/PA)
- Transformations Care Network
-
Martinsburg, WV
FULL_TIME
- Join us at Harmony, a member of Transformations Care Network (TCN), as we embark on an exciting journey to empower Behavioral Health Advanced Practice Providers (NP/PA) like you to make a difference i...
- 11 Days Ago
Provider Network Analyst -- WV Health Population -- Northgate-400 Association Dr.
- CAMC Health System
-
Charleston, WV
FULL_TIME
- The Provider Network Analyst Senior is responsible for research and analysis related to provider network issues. ;The incumbent will support new business provider recruitment and contracting and/or co...
- 2 Months Ago
Provider Network Analyst -- WV Health Population -- Northgate-400 Association Dr.
- CAMC Health System
-
Charleston, WV
FULL_TIME
- The Provider Network Analyst Senior is responsible for research and analysis related to provider network issues. ;The incumbent will support new business provider recruitment and contracting and/or co...
- 2 Months Ago
Provider Network Specialist jobs at Popular Companies
Network Engineer
- Apex Systems
-
Sumter, SC
- Title of Position: Network Technician Location (city & campus): Sumter, SC (Shaw AFB) Contract Length: 6 month Contract ...
- 6/12/2024 12:00:00 AM
Network Engineer
- QinetiQ
-
Reston, VA
- Company Overview We are a world-class team of professionals who deliver next generation technology and products in robot...
- 6/11/2024 12:00:00 AM
Engineering - Network Engineer Mid
- Pyramid Consulting, Inc
-
Enon, OH
- Immediate need for a talented Engineering - Network Engineer Mid. This is a 12+ Months Contract opportunity with long-te...
- 6/11/2024 12:00:00 AM
Network Technician/Network Engineer/Network Support Engineer(NO C2C CANDIDATES considered)
- Sharp Decisions
-
Graham, NC
- Title : Network Technician/Network Engineer/Network Support Engineer(NO C2C CANDIDATES considered) Contract duration : 1...
- 6/10/2024 12:00:00 AM
Network Engineer
- Kinettix
-
Kahului, HI
- Job Description: Independent Contractor Contract to Hire Job Title: Network Technician Responsibilities: Work a minimum ...
- 6/9/2024 12:00:00 AM
Sr. Specialist Network Engineer
- IT
-
Phoenix, AZ
- Nestlé Information Technology is the digital arm of the world’s largest nutrition, health, and wellness company. With 15...
- 6/8/2024 12:00:00 AM
Network Engineer
- Raytheon Technologies
-
Sterling, VA
- Date Posted: 2024-02-06 Country: United States of America Location: VA543: 22270 Pacific Blvd, Dulles 22270 Pacific Boul...
- 6/8/2024 12:00:00 AM
Network Engineer
- Leidos
-
Norfolk, VA
- Description Leidos is a FORTUNE 500 company bringing a mix of innovative technology and sector expertise to customers in...
- 6/7/2024 12:00:00 AM
About West Virginia
West Virginia (/vərˈdʒɪniə/ (listen)) is a state located in the Appalachian region in the Southern United States and is also considered to be a part of the Middle Atlantic States. It is bordered by Pennsylvania to the north, Maryland to the east and northeast, Virginia to the southeast, Kentucky to the southwest, and Ohio to the northwest. West Virginia is the 41st largest state by area, and is ranked 38th in population. The capital and largest city is Charleston.
West Virginia became a state following the Wheeling Conventions of 1861, after the American Civil War had begun. Delegates from so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$52,858 to $79,028
Most Popular Cities in West Virginia for Provider Network Specialist Jobs
What does a Provider Network Specialist do?
Provider Network Specialist in Anderson, IN
Creates, maintains, and ensures the integrity of the provider data in DHP’s multiple claims payments systems and provider interface programs.
January 07, 2020
Provider Network Specialist in Tucson, AZ
Identifies and works with the provider to address education needs relative to DHP’s new product lines/expansions, utilization management, claims submission, and back-end issues resolution requirements of each assigned provider’s contract.
January 12, 2020
The Provider Network Specialist will work closely with all facets of the business, primarily with Care Management, Claims and Business Development.
January 08, 2020
Provider Network Specialist in Oakland, CA
Build and maintain a successful working relationship with Integra Managed Care and network providers.
December 03, 2019