Network Operations Administrator

Where

Baltimore, MD

What you'll be doing

Responsible for general oversight of provider network financials, including monthly action plans, reviews, and verification. Provides guidance on strategic plans, vision, and action plan development for the networks. Verifies and signs both capitation checks and claims payments. Responsible for network development, including physician contracting, rate negotiations, physician network relationships, physician network communication, physician recruitment, and network partners. Participates in network and company meetings, including physician board of directors, quality management, financial/bonus, operation, committee responsible for maintaining compliance to CMS and company policies and guidelines. Works directly with chief operating officer, medical directors, sales, marketing, finance, medical economics, billing, coding, and health services, contracting and legal to accomplish objectives.

What your background should be

At least three years of related healthcare experience. Previous management experience preferred. Experience in physician relations, managed care, and/or hospitals preferred. Valid driving license, vehicle, and insurance required.

Required Schooling / Training

Bachelor degree required, master degree preferred.

Who is the client company

This is a global health insurance service company that offers health, dental, supplemental insurance and Medicare plans to individuals, families and businesses.

If you are interested in this position, send your resume to apply@kochdavis.com