Network Provider Consultant

1 week ago


Helena, Montana, United States Innova Solutions Full time
Job Description

Innova Solutions is seeking a highly skilled Network Provider Consultant to join our team. As a key member of our organization, you will be responsible for analyzing, researching, and applying business rules to fulfill requests from providers regarding additions, deletions, and changes to their information used for claims processing, membership assignment, and directory purposes.

Key Responsibilities:
  • Analyze and apply business rules for provider information updates.
  • Contract, credential, and maintain provider data.
  • Support special projects and manage workflow.
  • Train team members on network contracting and credentialing.
  • Identify process gaps and suggest improvements.
Requirements:
  • Bachelor's degree plus 1 year of experience with provider network contracting and credentialing systems, or 5 years of experience in the healthcare industry.
  • Strong written and verbal communication skills, including interpersonal skills.
  • Ability to develop training materials and serve as an advisor to staff.
  • Proficiency in Microsoft Office products, including analytical tools, and experience in developing reports.
Preferred Qualifications:
  • Subject Matter Expert in the Professional Provider Credentialing Process.
  • 2 years of experience with current government-sponsored health insurance networks.
  • Knowledge of healthcare delivery systems, claim costing analytics, and provider network adequacy analytics.

Innova Solutions offers a competitive pay range of $19 to $21 per hour and a comprehensive benefits package, including medical and pharmacy coverage, dental and vision insurance, 401(k), and more. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.



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