provider network consultant job description

Also refer to theGovernment Medicaid Provider Network Consultant List, which shows your designated PNC according to your provider type and county, as outlined below: PNCs in the downstate area service all provider types. network consultant Our Provider Network Consultants (PNCs) serve as the liaison between BCBSIL and our independently contracted provider community, developing and maintaining working relationships with their assigned providers. They may also have programming skills, cloud computing knowledge, or experience with operating systems. Please help us protect Glassdoor by verifying that you're a They are able to provide solutions that are reliable and efficient. In addition, the lawyer is expected to interact with clients via telephone, email, or in person. The Provider Network Solutions Consultant is a dynamic, multifaceted role that works closely with management- external customers- internal business- and analytical units to deliver successful major initiatives. When it comes to case preparation, balance networking with preparing for interviews. We have included network consultant job description templates that you can modify and use. - Instantly download in PDF format or share a custom link. What does network Consultant do? BlueAdvantage Network Provider Consultant Job Summary - The BlueAdvantage . To write an effective consultant, network job description, begin by listing detailed duties, responsibilities and expectations. Instantly Access Millions of Professionals. Learn about the key requirements, duties, responsibilities, and skills that should be in a network engineer job description. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent. . In addition, they provide strategic leadership insights on an interim basis. Consultants often specialize in a specific area, and those who aren't independent contractors may work for larger consulting firms that hire out their services. Top 5 network engineer interview questions with detailed tips for both hiring managers and candidates. Senior network managers are information technology (IT) professionals who are responsible for installing and maintaining computer network systems for an organization. *Knowledge of the health care industry and BCBSIL private business. Wenn The job role might fluctuate based on the requirements or needs of a company, but they commonly include hardware/software installation, server planning, and availability, disaster recovery, network globalization, and Datacenter network setup. Thank you for your time!" Provider Enrollment Specialist Job Description, Provider Relations Advocate Job Description, Provider Relations Representative Job Description, Ensures policies are developed as appropriate for areas of responsibility and that the processes are developed and maintained to adhere to these policies, Conduct regular visits to providers to introduce new initiatives and monitor success of those in place and to identify issues and ensure effective problem resolution to maintain strong relationships, Works with the team to ensure features, stories, and tasks are entered, maintained, and tracked in required Agile tooling solutions, Partner with the provider community to develop the capability for sustained, integrated consumer interaction programs building consumer advocacy and loyalty, Influence provider culture and strategy to elevate the capability of the provider community to support the ever-changing healthcare environment, Need to work independently and within an integrated team in a highly matrixed environment, Clinical background and/or MBA not required but a plus, Must reside in Alexandria, LA or within a commutable distance, 5 years provider engagement or network management experience preferred, Must reside in Colorado Springs or within commutable distance, Registered Nurse with no restrictions in state required to practice, Prior experience in physician offices or working with providers, Must reside in Layfayette, LA or within a commutable distance, Experience with ACO, Risk-Based, Value-Based Contracting highly desireable, Bachelors Degree or RN designation required, Bachelor Degree and 4 years experience in strategic planning, market research, product development or network management in health care industry OR Masters/Professional Degree and 3 year of experience strategic planning, market research, product development or network management in health care industry OR 6 year of experience strategic planning, market research, product development or network management in health care industry, Ability to drive consensus and influence at various levels of the organization, Verbal and written communications skills including interpersonal communication skills to work across departments, present findings and status of projects, build relationships and garner information from various sources, Experience interacting with staff/management across multiple departments and levels, 1+ years of experience in provider relations and network communications and interactions, 1+ years of healthcare, managed care or marketing experience, Able to work core business hours, Monday - Friday, 40 hours, Work overtime, weeknights and weekends, as required, Travel up to 75% of the time within assigned sales territory, Access to reliable transportation with valid drivers license that will enable you to travel to client and/or sites within designated area, Requires strong relationship building skills with physicians, office staff, payers and members of the healthcare network, Must be able to work independently in both an organizational start up mode growth and maintenance mode, Must be highly organized and able to manage multiple projects, dashboards, and multiple high-level priorities, Communicates clearly and effectively in written and verbal conversations, Works under short deadlines, is flexible, open to change based on leadership dialog, Knowledge of the managed care/value-based healthcare industry preferred, 5 years of provider engagement or network management experience preferred, Bachelors Degree in Nursing, Science or equivalent work experience, Current unrestricted nursing licensure required in Kentucky, Travel to physician offices within the Kentucky up to 75% of the time, Registered Nurse with current unrestricted Massachusetts state license, Proficiency in CMS marketing rules and regulations, 6+ years related work experience in Network Management, Network Operations and or Provider Relations- equivalent combination of transferable experience and education, Related Bachelors degree or additional related equivalent work experience, 5+ years Network Management, Network Operations and or Provider Relations work experience or equivalent combination of transferable experience and education, 2+ years experience utilizing financial models and analysis in negotiating rates with providers, Ability to identify opportunities to improve performance and develop strategies to facilitate change, Ability to effect change, perform critical analysis, plan and organize effectively and support needs of medical group, Demonstrate proficiency in use of job related technology applications, Must be able to prioritize and manage multiple projects simultaneously, Requires initiative, sound judgment, and the ability to work under pressure in a constantly changing environment balancing multiple priorities and utilizing resources aggressively, Requires strong verbal and written communication skills to effectively communicate, Consulting experience with Medical Groups highly desirable, Experience in outpatient physician practice management preferred, Experience in medical case management/discharge planning/project management highly desirable, Experience in the use of PC based systems is essential, Possess knowledge and experience in effective care management for the senior population balancing quality with cost effective management interventions, Ability to identify and manage multiple complex issues in a flexible and professional manner. The ideal candidate will be able to multi-task and be able to endure long hours. However, if you don't take the time to make an introduction, or if you end the conversation with a lack of warmth and appreciation for the other person, you'll have left the impression that you're not interested in meeting them. At least two years' experience in network consultancy. *Working knowledge of claims processing systems. Find Surveys For This Job, Employers: Typically a job would require a certain level of education. The Network consulting is associated with limited physical demands or risks; they perform the remote work as per the need of the client. Typically a job would require a certain level of education. Network Relations Consultant resume example - LiveCareer It is difficult to reach out to your network in times of need if you only value your network when you need them.professional neglect to foster and maintain their network over time regardless of their employment situation. provider engagement consultant They are responsible for designing, setting up and maintaining computer networks at either an organization or client location. include: Desired experience for message, contactez-nous l'adresse verdade. Our innovative and growing company is looking for a provider engagement consultant. Extensive knowledge of network technologies and architecture. There are a few things you can do to improve your chances of winning more consulting clients. Se continui a visualizzare Microsoft, Cisco, or CompTIA Network certification preferred. For example, powerline networks are great for connecting large areas quickly and easily. Training staff, preparing user manuals for network deployment, and providing end-user support. The average Provider Network Specialist salary in the United States is $69,205 as of May 01, 2023, but the range typically falls between $57,289 and $85,527. *Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience. Bachelor's and Master's Degree A recent study by Payscale found that English-speaking engineers make on average $83,223 per year in the United States. 306 Provider Network Contracting Consultant jobs available on Indeed.com. Among other services, your assigned PNC can: We have several PNC teams. 1. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. which equates to a yearly salary of $83,448. In the world, there are many types of networks. Each type of network has its own unique advantages and disadvantages. Ci Provides a consistent optimal customer experience, including handling customer's transactional needs. However, some experienced professionals may charge a much higher fee than others. provider network Onze Press Refresh to reload the page, or you can can close the page if you are finished. an. This involves understanding how different parts of the system interact and how they can be interconnected to create a more efficient or reliable whole. Our company is growing rapidly and is hiring for a network consultant. Supporting Commercial, MA, Medicaid, Medicare and Medicaid Dual Eligible provider contracting of ancillary and ancillary facility providers across all lines of . Our experienced staff of Government Provider Network Consultants (PNCs) is dedicated to building and maintaining strong working relationships with our providers. includes: Create a Resume in Minutes with Professional Resume Templates. ThePNC team assigned toyour territory specializes in investigating issues, producing data and developing solutions. If you're able to build a good relationship with potential clients, they'll be more likely to trust you and refer others to you. Most networks recommend a rate of around $150 ? Many network engineers have to have a good understanding of computers and coding in order to help with networking projects. Aydanos a proteger Glassdoor y demustranos que eres una persona real. This means that if you are a creative writer or have special knowledge in a certain field, you may be able to charge much more. Collaborating with internal departments to build and maintain network infrastructures that meet business needs. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Caso continue recebendo esta mensagem, List any licenses or certifications required by the position: They might create designs for emergency response systems, or they might study ways to improve security at sites where sensitive data is stored. Proven management skills are also necessary to reach this advanced position. At times the travel is required to the client sites may be required as per the requirement. Responsibilities for provider engagement consultant, Qualifications for provider engagement consultant. 1+ years of healthcare, managed care or marketing experience. message, please email Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. includes: Create a Resume in Minutes with Professional Resume Templates. Our dedicated Professional Provider Network Consultants(PNCs) provide service tomore than 25,000 contracted physicians and medical groupsthroughout Illinois and Northwest Indiana. Provider Network Consultant job in Jacksonville at Health Care Service After careful analysis, they suggest changes, if any, for better functionality along with a cost-benefit analysis. ein Mensch und keine Maschine sind. Graduate, Business, Health Care, Network Management, MBA, Education, Science, Nursing, Finance, Associates. External link You are leaving this website/app (site). HMO PNCs also serve as an internal voice for the MG/IPAs regarding the administration and delivery of managed health care, such as quality improvement and utilization management programs, the implementation of legislative requirements, and preventive care and wellness initiatives. Additionally, consultant salaries can be as high as $16,417 per month. Aydanos a proteger Glassdoor verificando que eres una persona real. Instantly Access Millions of Professionals, PMP, CCIE, CCNP, BLS, CEH, II, IAT, CCSE, CISSP, AHIMA. Networks can be used to connect machines in a office or to share files between different departments. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, our Government Programs Provider Relations team, Government Medicaid Provider Network Consultant List, Institutional Provider Network Consultant List, Assist you with adhering to financial requirements and. Network Consultant Job Description | Velvet Jobs 5. Consultants oversee the entire network to ensure the organizations productivity. Our Ancillary Provider Network Consultants are available to provide training and discuss BCBSIL policies and procedures, billing and contractual or operational issues. A computer network is a networking system in which computers can communicate with each other. Provider Relations Manager Job Description, Behavioral Health Provider Job Description. Next, look for referrals. This professional is skilled in providing technical assistance needed for equipment, installations, and system maintenance. The advantage of using an expert network is that party members can quickly and easily find the right experts to speak with. With years of experience in the field, the Consulting Network Engineer is well-equipped to handle any network or server issue. To view this file, you may need to install a PDF reader program. 4. para informarnos de que tienes problemas. Aidez-nous protger Glassdoor en confirmant que vous tes une personne relle. If youre an Independent Practice Association (IPA), Medical Group, Physician Hospital Organization (PHO), Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) in Northwestern Illinois, your designated PNC can be found on theMedicaid Northwest, Cook, Collartab in theGovernment Medicaid Provider Network Consultant List. Anthem, Inc. - Network Relations Consultant Morrisville, NC, 11/2013 - 01/2015. enviando un correo electrnico a They are experienced in many different aspects of their work, and are looking to help their clients get the most out of their equipment. A consultant might be a network architect, system administrator, security specialist or a related work specialist in the Telecom world. Network Security Consultant Job Description, Network Engineer Voice & Network Job Description, Manage network technical services strategy and planning process for network related teams, Drives architecture standards across Network team, Participate in examining IT infrastructure and evaluate and report out findings, Assist in the design of and project management for implementation new technologies (Data Center, Enterprise Network Video/Voice/Data) for clients, Provide training to the Operations and BU transport teams to help support the Transport Network, Creation of a Certification Program for training and to keep track of what groups are certified after the training is complete, PCRF/SGSN/GGSN Integration Commissioning and administration (Charging, performance, O&M GPRS and UMTS interfaces Gr, Gn/Gp, Gs, Gd, Gb and IuPS), Excellent knowledge of SS7 protocol and procedures (SCCP, MTP2, MTP3b, MAP, RANAP, BSSGP, BSSGP+ and SIGTRAN), ATM and Frame Relay technologies, Strong background in networking infrastructure and network traffic analysis tools, Support Government programs and clients by handling day to day client support activities, coordinate implementations, gathering and analyzing data from State and Government websites for excluded and disciplinary action for pharmacy providers, Attending conference calls or on site Managed Care Organization meetings to discuss/confirm implementation activities, such as producing pharmacy provider overlays, Tracking and reporting the progress of pharmacy solicitation activities, identifying pharmacy providers that need to obtain Medicaid ids, Verifying processes such as the pharmacy roster and confirmation of member ID card format, Production of reporting to support the Managed Care Organization or State requirement/request, Upon implementation the Consultant is responsible for analyzing and identifying issues and working with internal partners to resolve them in a timely manner, Lead small team of technician to analyze requirements, prepare solutions, present to the client, Incident troubleshooting and reporting , reporting on SLA, Root Cause, Plan, Test, review changes and provide technical guidance to implementation team, Prepare/Update operational manuals, Standard operating procedures, Proven expertise in design, implementation and maintenance of complex network solutions that ensure high security and end-user transparency, while maintaining rigorous operational service levels, Candidates must have at least 5 years previous internal network administration or external network consulting experience in Microsoft environments, Minimum 8 years of progressive data network experience in a large, complex, fast paced environment, Strong operations efficiency orientation (process, costing ) and ability to effectively manage ongoing operations within budget while identifying opportunities for ongoing efficiency, familiarity with ITIL framework, Experience working in a geographically dispersed, global organization with responsibilities spanning multiple continents, Develop various project deliverables (Network Deployment Workbook, assessment reports, workshops, migration plans, as needed for each assigned customer engagement), Acquire and maintain expert level knowledge in two or more areas such as data center, campus/end-user, hyper-converged, SDN, wireless, and firewall services, Understand, collect, propose, and communicate requirements to all solution stakeholders (internal and external), Serves as a subject matter expert for automation and orchestration, providing assistance & technical guidance to less experienced team members, Design and implementing data center automation frameworks and flow models for automating processes, Develop specifications and test criteria for workflows that will automate process, Identify, architect, design, and implement new automation workflows to handle various facets of IT System Management and Administration consisting of but not limited to virtual environment(s) creation and decommission, data validation procedures and integration with Web front-end UIs, Network Tier, Storage & Compute Tier using API and WSDL calls, Role will be accountable for working multiple internal departments to in delivering enterprise automation solutions, Develop documentation for automation as required by the application support teams for acceptance of systems changes into production, Acquire and maintain expert level knowledge in two or more areas such as data center, campus/end-user, hyper-converged, Able to perform a wide variety of technical and organizational tasks and may lead or direct the work of others, Professional or lower level industry certifications within the network engineering field such as CCNP (any track), JNCIP (any track), Certifications and/or significant exposure in other technical areas such as MCSE, CEH, security, UC, Experience with cloud-based services (SaaS, PaaS, IaaS), You will have experience in Engineering, Urban Drainage, Waste Water Networks, Hydraulics, Distribution Networks, Modelling (InfoWorks CS, RS, Know, follow, and enforce company, department, and team standards and expectations for documentation, including maintenance and support documentation, Design and implement mobile network infrastructures as well make improvement recommendations, Provide assessment of requirements and definition involving clients processes and network, Support the creation of guidelines and strategies for network evolution/growth, Evaluate and understand customers network in order to develop upon it and influence clients decisions, Supporting, executing and managing deployment of complex mobile network implementation or systems for this context, Work with Business requirements and processes, Work in different telecom services across all eTOM areas (Fulfillment, Assurance and Operations Support& Readiness), involving Wireless in both telco customers segments (Corporate and Consumer), Conduct projects in Mobile Network contexto, Taking the responsibility and taking care of the consequences of making a decision, Using all data and information available to analyse and understand a situation, with the aim of supporting decisions, Interpret Customer needs, assessing the full requirements, identifying solutions to standard and non-standard requirements, Ability to explain difficult technical concepts to a variety of audiences, Expertise on pre-sales activities, planning and implementations across a wider range of ICT Infrastructure elements (security, wan optimization, load balancing ) is an advantage, Works closely with Georgia Medicaid, contracting and provider services, Works closely with hospital, ancillary (including behavioral health and managed long term care) and professional providers (including behavioral health), Supporting quality initiatives such as Gaps in Care, HEDIS, QARR and clinic day arrangements, Provide responsive and professional customer service to Medicaid providers, Help providers navigate systems efficiently and accurately to verify eligibility and verification of benefits, Liaise necessary demographic requests to ensure timely submission and update(s), This individual may be managing small to large *projects* on their own, Project engineering for New York TriState area is primarily Cisco-focused, Must possess excellent troubleshooting skills and be flexible with hours, Fundamental operational knowledge while maintaining ability to create and implement strategic plan, Experience with Cisco and Arista Networks, 3 or more years of experience as Linux systems administrator, Ability to quickly assess information and make rapid decisions, Ability to lead organizational change and transformation.
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