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Network Management Representative, Hospital Relations
Network Management Representative, Hospital RelationsVisiting Nurse Service of New York • Manhattan, NY
Network Management Representative, Hospital Relations

Network Management Representative, Hospital Relations

Visiting Nurse Service of New York • Manhattan, NY
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  • [job_card.full_time]
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Network Management Representative, Hospital Relations

Manhattan, New York Provider Relations
Apply Now Job ID R010681 Overview

Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.


Compensation:

$30.71 - $38.41 Hourly

What We Provide

  • Referral bonus opportunities
  • Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
  • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
  • Employer-matched retirement saving funds
  • Personal and financial wellness programs
  • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
  • Generous tuition reimbursement for qualifying degrees
  • Opportunities for professional growth and career advancement
  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

  • Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
  • Prepares materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
  • Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
  • Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
  • Coordinates provider site visits, as needed.
  • Coordinates and attends meetings to serve as a resource and addresses provider issues.
  • Updates and maintains provider manuals with current Health Plan policies and procedures.
  • Updates and proofs provider directories.
  • Assists providers in triaging billing and claims disputes.
  • Participates and collaborates with Compliance on Department of Health and internal audits.
  • Participates in special projects and performs other duties as assigned.

Qualifications

Licenses and Certifications:

  • Driver's license, required


Education:

  • Bachelor's Degree or equivalent work experience in a health care setting, required


Work Experience:

  • Minimum three years health care experience, required
  • Knowledge of government programs, including Medicare and Medicaid, preferred
  • Prior experience in Provider Relations, preferred
  • Reliable transportation to work sites, required

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Network Management Representative, Hospital Relations • Manhattan, NY

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