Position: Provider Network Consultant
Location(s): On-site/Hybrid in Chicago, Tulsa OK, Albuquerque NM, and Helena MT
Compensation: $21.00 per hour
Job Description:
This position is responsible for analyzing and updating provider data for claims processing, membership assignment, and directories. Manages contracting and credentialing for Facility and Professional providers across all lines of business. Supports special project implementation, tracks progress and assists in workflow management. Helps train team members on network contracting and credentialing rules, while identifying process gaps and recommending improvements.
Required Job Qualifications:
– HS Diploma/GED
– 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
– Skills to develop training materials and act as an advisor to staff
– Experience and proficiency in Microsoft Office software products including analytical tools/developing reports.
Preferred Job Qualifications:
– Bachelors Degree
– 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