Healthcare Network Specialist

1 week ago


MagstattleBas, Grand Est, United States Nebraska Total Care Full time
{"h1": "Network Specialist II Job Description", "p": "At Nebraska Total Care, we're transforming the health of our communities, one person at a time. As a Network Specialist II, you'll play a critical role in improving quality and financial outcomes within our provider network.

Your key responsibilities will include:

* Conducting initial provider orientations and ongoing educational outreach
* Educating providers on policies and procedures related to referrals, claims submission, credentialing documentation, and more
* Enhancing account relationships by investigating and resolving provider matters
* Engaging providers in Patient Centered Medical Home initiatives
* Analyzing HBR and HEDIS data to create reports and dashboards
* Acting as a liaison between providers and the health plan to improve financial and quality performance

If you're passionate about healthcare and have a strong background in managed care and provider reimbursement, we encourage you to apply.

**Requirements:**

* Bachelor's degree in a related field or equivalent experience
* 2+ years of combined managed healthcare and provider reimbursement experience
* Claims processing and/or managed care experience preferred

**What We Offer:**

* Competitive pay
* Comprehensive benefits package
* Opportunities for professional growth and development

**Equal Opportunity Employer:**

Nebraska Total Care is an equal opportunity employer that values diversity and inclusion. We welcome applications from qualified candidates of all backgrounds.

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