Provider Network Consultant
Company: Integrated Resources
Location: Tulsa
Posted on: April 24, 2024
Job Description:
JOB TITLE: Provider Network Consultant
JOB LOCATION: Tulsa, OK (Hybrid)
JOB DURATION: 24+ months + CTH
Job Description:
- This position is responsible for the analysing, researching,
and applying business rules to complete requests received from
providers regarding adds/deletes/changes to their information used
for claims processing, membership assignment, and directory
purposes.
- This position is responsible for contracting, credentialing,
and maintaining Facility / Professional provider data to support
marketing, network contracting across all lines of business.
- This role involves supporting the implementation of special
projects, assisting with tracking of various phases of a project
and managing workflow.
- This position includes assisting management in familiarizing
and training team members with the various business rules in
network contracting and credentialing across all lines of business.
In addition is responsible for identifying gaps in processes and
suggesting process improvement strategies.
Required Job Qualifications:
- Bachelor's degree plus 1 year of experience with Provider
Network contracting and credentialing systems OR 5 years of
experience in the Health Care industry.
- Written and verbal communication skills including interpersonal
skills. Skills to develop training materials and act as an advisor
to staff.
- Experience and proficiency inn Microsoft Office software
products including analytical tools. Experience developing
reports.
Preferred Job Qualifications:
- Subject Matter Expert for the Professional Provider
Credentialing Process
- 2+ years of experience with current government sponsored health
insurance networks.
- Knowledge of health care delivery systems, claim costing
analytics, and provider network adequacy analytics.
#admzr5
Keywords: Integrated Resources, Broken Arrow , Provider Network Consultant, Professions , Tulsa, Oklahoma
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