Network Management Professional

4 weeks ago


Albuquerque, New Mexico, United States Magellan Health Full time
About the Role

We are seeking a skilled Network Management Specialist to join our team at Magellan Health.

This is an exciting opportunity to contribute to the development and maintenance of our physician, practitioner, group, and/or facility services delivery system in small to mid-size markets defined by membership, number of providers, business operating units, and lines of business.

Responsibilities
  • Interact with all areas of the organization to coordinate network management and administration responsibilities.
  • Assess network needs, analyze composition, and recruit individual, group, and/or organizational providers to meet network adequacy standards and assure quality networks.
  • Conduct contracting and amendment initiatives, provide issue resolution and complex trouble shooting for providers.
  • Coordinate Public Policy Research Center activities to maintain current credentialing status and evaluate quality of care issues and complaints against providers.
  • Manage ongoing audits of provider compliance with policies and procedures as well as contractual obligations for multiple customers.
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 a related position or field.
Compensation

The estimated salary range for this position is between $45,655 and $68,485 per year, based on national data and factors such as education, experience, and location.

This position may be eligible for short-term incentives as well as a comprehensive benefits package, including health, life, and voluntary benefits that enhance your physical, mental, emotional, and financial wellbeing.

About Magellan Health

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. We value diversity and inclusion in the workplace and strive to create a culture that supports and empowers our employees.



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