Provider Network Director

A company is looking for a Director Provider Network to oversee the development and optimization of the provider network while managing claims issues. Key Responsibilities Analyze claim issues and implement strategies for resolution Establish and maintain relationships with healthcare providers and negotiate contracts Develop long-term strategies for network growth and conduct performance monitoring Required Qualifications 10+ years of experience in the health care industry 8+ years in a network management role with accountability for business results 5+ years of experience in provider contracting and financial modeling In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS) and related systems

Apr 30, 2025 - 23:56
 0
Provider Network Director
A company is looking for a Director Provider Network to oversee the development and optimization of the provider network while managing claims issues. Key Responsibilities Analyze claim issues and implement strategies for resolution Establish and maintain relationships with healthcare providers and negotiate contracts Develop long-term strategies for network growth and conduct performance monitoring Required Qualifications 10+ years of experience in the health care industry 8+ years in a network management role with accountability for business results 5+ years of experience in provider contracting and financial modeling In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS) and related systems