Network Healthcare Provider Relations Specialist

4 weeks ago

Wilmington, North Carolina, United States Johns Hopkins HealthCare Full time

About the Role:

We are seeking a skilled Network Relations Consultant to join our team at Johns Hopkins Health Plans. As a Network Relations Consultant, you will play a critical role in developing and maintaining collaborative relationships with network providers across all of our lines of business.

Key Responsibilities:

  • Develop and maintain a collaborative relationship with all network providers across all JHHP's lines of business.
  • Act as a liaison between the network providers and JHHP, monitoring network providers to ensure network access standards are met, ensure compliance with provider contract and regulatory processes and requirements, promoting JHHP's strategic initiatives and providing extensive training on all JHHP lines of business to ensure that network providers have updated policy and procedure information.
  • Educate and train providers on JHHP systems and quality goals.
  • Maintain ongoing communication with providers in assigned territory, facilitate regular provider meetings, and ensure timely assistance and resolution of any issues presented.

Requirements:

  • 2+ years' current experience in healthcare delivery program or insurance setting; experience should include:
  • Provider Relations functions
  • Managed care/provider contracting, familiarity with provider contract language and terms
  • Knowledge of managed care concepts and information systems (FACETS experience a plus)
  • Requires a sound knowledge of successful servicing, training, relationship building, negotiation techniques and an awareness of healthcare contracting terms
  • Bachelor's degree in business management or healthcare administration or related discipline preferred
  • Requires strong interpersonal skills to effectively communicate and interact with diverse groups of physicians, office staff, and business-related associates
  • Requires basic computer skills and familiarity with various Microsoft software applications
  • Requires strong ability to prioritize multiple initiatives and assigned tasks

About Johns Hopkins Health Plans:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments.

JHHP is a leader in provider-sponsored health plans and is poised for future growth. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.

What We Offer:

  • Minimum 25.73 per hour - Maximum 42.48 per hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE

Equal Employment Opportunity:

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

  • Network Healthcare Provider Relations Specialist

    4 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins HealthCare Full time

    About the Role:We are seeking a skilled Network Relations Consultant to join our team at Johns Hopkins Health Plans. As a key member of our team, you will develop and maintain collaborative relationships with network providers across all our lines of business.Key Responsibilities:Act as a liaison between network providers and JHHP, ensuring network access...

  • Senior Provider Network Manager

    4 weeks ago

    Wilmington, North Carolina, United States Elevance Health Full time

    Job SummaryWe are seeking a highly skilled and experienced Senior Provider Network Manager to join our team at Elevance Health. This role will be responsible for developing and managing our provider network through contract negotiations, relationship development, and servicing.Key ResponsibilitiesDevelop and implement strategies to expand and maintain our...

  • Digital Network Exploitation Specialist

    3 weeks ago

    Wilmington, North Carolina, United States Belay Technologies Full time

    Job DescriptionBelay Technologies is a leading provider of technology and engineering solutions to the DoD and commercial markets. We are seeking a highly skilled Digital Network Exploitation Specialist to join our team.The successful candidate will have a solid understanding of logical/physical IP core infrastructure, communication devices, and how they...

  • Senior Network Installation Specialist

    4 weeks ago

    Wilmington, North Carolina, United States Leidos Full time

    Senior Network Installation SpecialistUnlock Your PotentialAre you passionate about network installation and thrive in a dynamic environment? This Senior Network Installation Specialist role at Leidos is for you. You'll lead network survey, design, and installations, ensuring compliance with commercial, TEMPEST, and NIST standards. Your expertise will make...

  • Healthcare Regulation Specialist

    3 weeks ago

    Wilmington, North Carolina, United States State of North Carolina Full time

    Job Title: Healthcare Regulation SpecialistWe are seeking a skilled Healthcare Regulation Specialist to join our team at the State of North Carolina. As a key member of our Health Service Regulation division, you will play a critical role in ensuring the health, safety, and well-being of North Carolina's citizens receiving services in adult care homes.Key...

  • Network Architect

    3 weeks ago

    Wilmington, North Carolina, United States Diverse Lynx Full time

    Job DescriptionWe are seeking a highly skilled Network Architect to join our team at Diverse Lynx LLC. As a key member of our IT department, you will be responsible for designing, implementing, and maintaining our data communication networks.Key ResponsibilitiesNetwork Planning and Design: Develop and implement data communication network plans to meet...

  • Cybersecurity Network Analyst

    4 weeks ago

    Wilmington, North Carolina, United States Independent Software Full time

    Cybersecurity Network Analyst Job DescriptionIndependent Software is seeking a skilled Cybersecurity Network Analyst to join our team. The ideal candidate will have experience with computer network exploitation, construction, and diagnostics of computer networks, network analysis, network threats and risks, incident response, and database research.Key...

  • Cybersecurity Network Analyst

    3 weeks ago

    Wilmington, North Carolina, United States Independent Software Full time

    About the Role:Independent Software is seeking a highly skilled Cybersecurity Network Analyst to join our team. As a Cybersecurity Network Analyst, you will be responsible for analyzing and identifying network threats and risks, as well as providing incident response and support to our Government team.Key Responsibilities:Analyze network packet information,...

  • Hearing Healthcare Specialist

    3 weeks ago

    Wilmington, North Carolina, United States HearingLife Full time

    Role OverviewHearingLife is a national hearing care company seeking a skilled Audiologist/Hearing Aid Dispenser to join our team in Wilmington, NC. As a Hearing Healthcare Specialist, you will provide clinical expertise to diagnose and treat hearing loss while ensuring a positive patient experience.Key ResponsibilitiesProvide quality care and aftercare of...

  • Network Systems Engineer

    4 weeks ago

    Wilmington, North Carolina, United States Amentum Full time

    We are seeking a highly skilled Network Systems Engineer to join our team at Amentum. The ideal candidate will have a strong background in network infrastructure, cybersecurity, and software-defined networking.Key Responsibilities: Support virtual learning network infrastructure to meet special requirements for each course. Troubleshoot network issues and...

  • Network Administrator Position

    4 weeks ago

    Wilmington, North Carolina, United States SKF Full time

    Job Summary:We are seeking a skilled Network Administrator to ensure the reliability, security, and efficiency of our data communications network at our Hanover Factory. The ideal candidate will have the skills and expertise to deploy, configure, maintain, and monitor all active network equipment, ensuring seamless network operations.Key Responsibilities:...

  • Travel Healthcare Specialist

    5 days ago

    Wilmington, North Carolina, United States Planet Healthcare Full time

    Job Opportunity: Travel RN Float PCU - Progressive Care UnitIn Wilmington, North Carolina, we are seeking a skilled RN to join our team as a Travel RN Float PCU - Progressive Care Unit. This 13 weeks, 36 hours per week position offers 12 hours, nights shifts in the dynamic PCU - Progressive Care Unit specialty.About the Job:Duration: 13 weeksHours: 36 hours...

  • Network Systems Engineer

    4 weeks ago

    Wilmington, North Carolina, United States Jacobs Full time

    Job Summary: Jacobs is seeking a highly skilled Network Engineer to join their team in the Hanover, MD area. The ideal candidate will have a strong background in network systems engineering and experience with virtual learning network infrastructure.Responsibilities:Support of virtual learning network infrastructure sufficient to meet special requirements...

  • Senior Network Systems Engineer

    4 weeks ago

    Wilmington, North Carolina, United States Amentum Full time

    We are seeking a highly skilled Network Engineer to join our team at Amentum. The ideal candidate will have a strong background in network systems engineering and a proven track record of designing and supporting virtual learning network infrastructure.Key Responsibilities: Design and support virtual learning network infrastructure to meet special...

  • Coding Compliance Specialist

    4 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins HealthCare Full time

    Job SummaryJohns Hopkins HealthCare is seeking a skilled Coding Compliance Specialist to join our team. As a key member of our operations team, you will play a critical role in ensuring the accuracy and integrity of our medical claims processing.Key Responsibilities Review and analyze appeals from providers to ensure benefits are applied correctly...

  • Healthcare Professional

    3 weeks ago

    Wilmington, North Carolina, United States Novant Health Full time

    Job Summary:Novant Health is seeking a skilled CNA/Health Care Aide to join our team. As a Patient Care Specialist, you will provide exceptional patient care and support to our patients and families.Responsibilities:Provide individualized patient care to meet the daily personal needs and comfort of patients.Perform Nurse Aide I skills as approved by the...

  • Travel Nurse RN PCU Specialist

    1 month ago

    Wilmington, North Carolina, United States Health Advocates Network-Nursing Full time

    Job Title: PCU Registered Nurse (RN)We are seeking a highly skilled and experienced PCU Registered Nurse (RN) to join our team at Health Advocates Network-Nursing. As a PCU RN, you will be responsible for providing high-quality patient care in a fast-paced and dynamic environment.Job Summary:The successful candidate will have a minimum of 3 years of recent...

  • Business Operations Specialist

    4 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins HealthCare Full time

    Job Summary:As a Business Analyst-Pharmacy (Pharmacy Operations Oversight Specialist) at Johns Hopkins Health Plans, you will play a critical role in developing and implementing oversight, monitoring, and audit plans related to pharmacy vendors and other contracted entities. Your expertise in data analysis, reporting, and project management will be essential...

  • Medical-Surgical Travel Nurse Opportunity with SkyBridge Healthcare

    1 month ago

    Wilmington, North Carolina, United States SkyBridge Healthcare Full time

    Medical-Surgical Travel Nurse OpportunitySkyBridge Healthcare is seeking a Registered Nurse with Medical-Surgical experience for a 13-week contract in NC. Our commitment to excellence and consultative approach has helped us become a leader in the Healthcare staffing industry.Key Requirements:1 year full-time RN Medical-Surgical experience within the last 2...

  • Travel Nurse Oncology Specialist

    1 month ago

    Wilmington, North Carolina, United States ALOIS Healthcare Full time

    Job Title: Travel Nurse Oncology SpecialistALOIS Healthcare is seeking a skilled Travel Nurse Oncology Specialist to join their team for a travel nursing assignment in a dynamic healthcare setting.Job Summary:The ideal candidate will have experience working with patients who have, or who are at risk of getting, cancer. As an Oncology Nurse, you will provide...