Network Management Specialist

🔥 2 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $45.7k - $68.5k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Magellan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 $101M Private Equity Round on 2004-01

Consulting • Insurance • Healthcare

Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.

📋 Description

• Support activities related to developing and maintaining physician, practitioner, group, facility, MPPS and organization service delivery systems • Interact with organizational areas to coordinate network management and administration responsibilities • Assess network needs and analyze network composition • Recruit providers to meet network adequacy standards and assure network quality • Conduct and coordinate contracting and amendment initiatives • Resolve complex provider issues and troubleshooting • Conduct provider education and provider relations activities • Conduct administrative provider site visits and coordinate report development • Coordinate PPRC activities related to credentialing status and quality-of-care issues and complaints • Manage ongoing audits of provider compliance with Magellan policies, procedures and contractual obligations • Develop work plans to address audit requirements • Draft, clarify and recommend policy changes affecting network management

🎯 Requirements

• Knowledge of National Committee for Quality Assurance (NCQA) requirements • Ability to work independently and prioritize activities • Intermediate knowledge of Microsoft Office Suite, specifically Excel • Strong presentation skills using PowerPoint • Minimum of 1 year experience in related position/field • GED or high school education required • Compliance with security responsibilities, security controls, legal, regulatory, contractual and internal policy requirements • Bachelor’s education preferred

🏖️ Benefits

• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary and other benefits • Benefits and perks supporting physical, mental, emotional and financial wellbeing • Tobacco-free workplace