Medical Network Manager

New
  • Location
    Lake Oswego, Oregon
  • Job type
    Contract/Temp to Hire
  • Salary
    $ 20 - $ 25 / Hour

Adecco is currently looking for a Medical Provider Network Manager to work for a large Health Insurance company located in Lake Oswego.  There is an option to work remotely from Portland or Vancouver under the right circumstances. Please note, this is not an entry level position, you must have experience in this industry.  

 

Please review the information below and apply now if you have a qualifications and knowledge our client is looking for.

 

In this role you will:

1. Develop the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management.

2. Coordinate with key internal stakeholders (e.g., finance, clinical, regional directors, provider relations, claims) and external customers (state agencies)

3. Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.

4. Establish and maintains strong business relationships with new and existing providers and state agencies.

5. Familiarity with state regulatory requirements that direct credentialing and contracting activities.

 

Must have qualifications/experience:

1. Assesses and interprets customer needs and requirements.

2. Identifies solutions to non-standard requests and problems

3. Works with minimal guidance; seeks guidance on only the most complex tasks

4. Solves moderately complex problems and/or conducts moderately complex analyses

 



  • Apply with Adecco

Reference number US_EN_99_028082_11896454