Network Development Manager

4 days ago

Orange, California, United States Regal Medical Group Full time

At Regal Medical Group, we are seeking an exceptional Network Development Manager to join our team. This role offers a competitive salary of $85,000 - $110,000 per year.

About the Role:

The successful candidate will be responsible for managing our provider network, ensuring seamless growth and development initiatives. Key responsibilities include:

  • Collaboration with Director of Network Management and Medical Management Team: Work closely with these teams to drive network growth and development, while meeting budgets.
  • Contract Preparation and Negotiation: Prepare and negotiate contractual agreements with providers during recruitment projects.
  • New Provider Orientation and Education: Develop and deliver training programs for new providers to ensure effective communication of company initiatives and processes.
  • Network Oversight: Oversee assigned networks to ensure provider deficiencies are addressed, working closely with Network Support staff and Medical Management counterparts.
  • Databases and Tools Maintenance: Maintain accurate databases and department tools with up-to-date information.
  • Provider Contract Coordination: Coordinate receipt, review, and processing of provider contracts, credentialing, and correspondence.
  • PACF Completion and Health Plan Submissions: Complete PACFs accurately and submit provider profiles to health plans.
  • Health Plan Directory Review: Review health plan directories for assigned networks, communicating adds/terminations/changes.
  • Provider Grievance Resolution: Assist with grievance resolution in accordance with contractual requirements and corporate policy.
  • Regulatory Compliance: Ensure contract compliance with DMHC, DHS, CMS, and other regulatory agencies.
  • Internal Liaison: Serve as internal liaison for Database, Claims, Customer Service, Medical Management, and Quality Management Departments.
  • On-Site Visits: Conduct on-site visits to physicians, physician groups, hospitals, and ancillary providers.
  • Quarterly Joint Operations Meetings: Facilitate quarterly joint operations meetings with contracted providers and office staff.
  • Database Maintenance and Accuracy: Oversee database maintenance and accuracy through audits.
  • Data Reporting: Ensure timely data reporting requirements are met, including eligibility and capitation reports.
  • Compliance and Confidentiality: Adhere to Employee Handbook policies and maintain patient confidentiality under HIPAA guidelines.

Requirements:

We seek a highly motivated individual with:

  • A minimum of 3 years' experience in Network Management, Contracting, or Provider Relations in a managed care setting, health plan, or large medical group administration.
  • Knowledge of contracting principles and tools.
  • Excellent verbal and written communication skills.
  • Proficiency in MS Office programs (Word, Excel, Outlook, Access, PowerPoint).
  • The ability to travel within our service area 70-80% of the time, with a valid driver's license and insurance.

What We Offer:

As a valued member of our team, you can expect a comprehensive benefits package, including:

  • Employer-paid comprehensive medical, pharmacy, and dental insurance.
  • Vision insurance.

  • Senior Network Project Manager

    3 weeks ago

    Orange, California, United States Rivka Development Full time

    We are seeking a highly skilled and experienced Technical Network Project Manager to lead our network-related projects effectively at Rivka Development.Position OverviewThis role involves managing daily operations, ensuring service delivery, analyzing key performance indicators, and maintaining strong client relationships. A robust technical background in...

  • IT Network Project Lead

    4 days ago

    Orange, California, United States Rivka Development Full time

    Technical Network Project ManagerWe are seeking an experienced and skilled Technical Network Project Manager to lead our network-related projects effectively. The ideal candidate will possess a blend of technical expertise and project management skills to manage daily operations, ensure service delivery, analyze key performance indicators, and maintain...

  • Network Infrastructure Architect and Manager

    3 weeks ago

    Orange, California, United States CHOC - Children's Health Orange County Full time

    OverviewCHOC - Children's Health Orange County is a leading destination for children's health, providing exceptional and innovative care to the pediatric population. We are seeking a highly skilled Network Architect and Manager to join our team.SalaryThe estimated salary range for this position is $131,206 - $216,466 per year, based on factors such as...

  • Network Management Specialist

    4 days ago

    Orange, California, United States Alignment Healthcare Full time

    **Job Title:** Network Management SpecialistAbout Us:Alignment Healthcare is a healthcare company that revolutionizes health care for seniors by leveraging its world-class technology platform, innovative care delivery models, deep physician partnerships, and serving heart culture.Job Description:We are seeking a skilled Network Management Specialist to...

  • Senior Network and Communications IT Manager

    3 weeks ago

    Orange, California, United States University of California Irvine Health Full time

    About This OpportunityJoin the University of California Irvine Health as a Senior Network and Communications IT Manager, overseeing the operation of campus and/or medical center communications and data networks, including telecommunications. As a key member of our team, you will plan, design, develop, install, and maintain communications and data network...

  • Provider Network Coordinator

    13 hours ago

    Orange, California, United States The Midtown Group Full time

    About The Midtown GroupOur company is committed to providing exceptional patient care and improving the health outcomes of our communities. We are a dynamic and growing organization that values innovation, collaboration, and excellence.Job DescriptionThis is an exciting opportunity for a skilled Contracts Manager to join our team. The successful candidate...

  • Networks Systems Director

    4 days ago

    Orange, California, United States Jobot Full time

    Job SummaryWe are seeking a skilled IT Manager to oversee and manage our company's IT infrastructure, ensuring the safety and security of our digital assets. The selected candidate will be responsible for maintaining computer systems, troubleshooting network issues, and leading the process of virtualization and software migrations.About the RoleOversee and...

  • Network Engineer

    3 days ago

    Orange, California, United States Falck Full time

    Job SummaryWe are seeking a highly skilled Network Engineer to join our dynamic IT team at Falck USA.This role is pivotal in ensuring the seamless operation and optimization of our network infrastructure, with a focus on hybrid domain setups, cloud migration, and stakeholder management.

  • Dealer Network Operations Manager

    7 days ago

    Orange, California, United States North American Companies Full time

    About the Role: As a Dealer Network Operations Manager, you will be responsible for leading our service team, providing exceptional customer service, and ensuring the service department operates safely and efficiently. This is an outstanding opportunity for a results-driven individual with a passion for taking care of customers, excellent organization...

  • Network Systems Specialist

    4 days ago

    Orange, California, United States Jobot Full time

    Our company is currently seeking a seasoned Network Systems Specialist to join our IT team. Based in Orange County, California, we are part of a leading automotive dealership group with a strong presence in CA, AZ, and NV.About the RoleThis full-time position comes with a competitive salary of $120,000 per year, plus comprehensive benefits, including...

  • IT Specialist

    3 weeks ago

    Orange, California, United States AmeriPharma Full time

    About AmeriPharmaAmeriPharma is a rapidly growing healthcare company where you can contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. Our ideal candidate is passionate about their role and willing to grow and change as the company evolves.We offer a full benefits package including medical, dental, vision, life...

  • Senior Network Voice Solutions Engineer

    7 days ago

    Orange, California, United States MDS (Micro-Data Systems) Full time

    Job Title: Senior Network Voice Solutions EngineerEstimated Salary: $120,000 - $180,000 per yearMDS (Micro-Data Systems) is seeking a highly skilled Senior Network Voice Solutions Engineer to join our team. As a key member of our engineering department, you will be responsible for designing, implementing, and maintaining our enterprise voice...

  • Hemostasis Network Administrator

    1 week ago

    Orange, California, United States CIBD Full time

    Job DescriptionCIBD is committed to providing comprehensive care for patients with rare, chronic inherited blood disorders. We are seeking a talented Hemostasis Network Administrator to manage the day-to-day operations of the USHTCN, including leadership and USHTCN member communications and policies/systems. This role requires excellent analytical skills,...

  • Residential Property Manager

    2 days ago

    Orange, California, United States RPM Development Group Full time

    Job Title:Residential Property ManagerAbout the Role:RPM Development Group is seeking an experienced Residential Property Manager to oversee the maintenance and upkeep of our residential properties in Orange, NJ.The ideal candidate will have a strong background in property management, excellent communication skills, and the ability to work independently with...

  • Diagnostic Imaging Specialist

    3 weeks ago

    Orange, California, United States Registry Network Inc. Full time

    Registry Network Inc. is a leading healthcare staffing provider with over 35 years of experience in delivering exceptional temporary healthcare services. Our mission is to aid in the delivery of these services while encouraging our healthcare professionals to achieve greater career enrichment and advancement.About Registry Network Inc.We are California...

  • Business Development Manager

    2 days ago

    Orange, California, United States VC3 Full time

    About VC3VC3 is an innovative IT services solution provider with a 25-year history of excellence. Headquartered in Columbia, SC, we offer cutting-edge managed services and cybersecurity solutions to our clients nationwide.Your RoleWe are seeking an experienced Business Development Manager to join our team. As a key member of our sales team, you will be...

  • Business Development Manager

    16 hours ago

    Orange, California, United States Fortis Fire & Safety Inc. Full time

    **Job Description**Fortis Fire & Safety Inc. is seeking an experienced Operations Manager to lead our Sprinkler and Fire Alarm division. As a key member of our leadership team, you will drive business growth and performance while maintaining operational excellence.**Responsibilities**Recruit, train, and develop a high-performing team to achieve business...

  • Therapist Development Manager

    1 week ago

    Orange, California, United States Burke Williams Full time

    About the RoleThe Massage Manager will play a critical role in driving business success by leading a team of experienced massage therapists.Responsibilities will include managing staff schedules, providing coaching and guidance, and ensuring compliance with company policies and procedures.A successful candidate will possess excellent leadership skills, a...

  • Business Development Manager

    3 weeks ago

    Orange, California, United States Wavves Logistics Llc Full time

    Unishippers Opportunity OverviewWe are seeking a talented Business Development Manager to join our team at Wavves Logistics Llc. As a key member of our sales team, you will be responsible for driving revenue growth and expanding our customer base.The ideal candidate will have a proven track record in business development, excellent communication skills, and...

  • Business Development Manager

    3 days ago

    Orange, California, United States Ironwall by Incogni Full time

    About the RoleWe are looking for a seasoned Sales Manager with a minimum of 5 years of experience in leading sales teams, particularly in B2B technology services and/or SaaS. The ideal candidate will have a strong understanding of Salesforce and be able to establish and maintain a culture of accountability within the organization.The Sales Manager will be...