Regional Network Administrator
The Regional Network Manager is responsible for the full range of provider services and services interactions within SynerMed managed groups, including working on end-to-end provider claim and call quality, ease of use of physician portal and future services enhancements and training and development of external provider education programs. The Regional Network Manager will design and implement programs to build and nurture positve relationships between the health plan, providers (physicians, hospital, ancillary, etc.) and practice managers. Responsibilities include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.
- 2+ years of provider relations and/or provider network experience, including experience training and an understanding of health plans.
- 1+ years pf experience with Medicare and Medicaid regulations
- Intermediate level of proficiency in claims processing and issue resolution
- Effective communication skills (written/verbal) with the ability to communicate with others clearly, tactfully and professionally. Exceptional presentation skills.
- Ability to work independently and remain on task and willing to accept responsibility and possess the desire to learn new tasks.
- Strong computer skills with a broad knowledge of software packages and intermediate level of proficiency with MS Office.
- Must be detail oriented, have good organizational and planning skills, with the ability to prioritize and meet deadlines from multi-staff members with the department.
- Valid CA driver's license and insurance with the ability to travel at least 90% of the time.
- High school diploma or GED with continued education. (Bachelors degree preferred)
SynerMed is a market-leading healthcare organization specializing in government-sponsored programs headquartered in Monterey Park, California. SynerMed is dedicated to innovating healthcare through an integrated system of tools, purpose-built web platforms, and professional services that connect physicians, members, hospitals and health plans. SynerMed's mission is to transform the healthcare system by rewarding high-quality and cost-effective care. For more information about SynerMed, visit www.synermed.com and www.synermedconnect.com.
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Monterey Park, CA
Fri, 5 May 2017 17:58:07 PDT