Provider Network Management Representative - Broward County

POSITION SUMMARY:

The Provider Network Management Representative (PNMR) is responsible for conducting orientation sessions, making educational visits, and solving provider issues.  The Provider Network Management Representative also ensures that the Health Plan has accurate information on providers within his/her designated territory.  The PNMR assists the Quality Management Department in the credentialing process, and the Contract Management Department with contracting efforts for new providers as needed and works with other areas of the Health Plan to ensure our members have access to quality care.

 

POSITION QUALIFICATIONS:

Bachelor?s degree in Health Care Management, Finance, Accounting or Business preferred.

Minimum 3-5 years of provider relations and/or provider contracting experience required.  Minimum 2-4 years provider/claims customer service experience or provider billing preferred.  Minimum 3-4 years of industry experience preferred.  Knowledge of managed care preferred.  Excellent written and verbal communication skills.  Strong organizational skills.  Proficient in basic software applications, i.e., Microsoft Word, Email, and Excel.  Demonstrated ability to present educational workshops to large groups of providers required

 

This job posting does not purport to describe all functions.  Associates may be assigned other duties, and the essential functions of the job may change or be changed from time to time.