Job ID: 298943
Provider Network Specialist
Regular / Day
We Are Hiring
Provider Network Specialist - FT, Days - 523 Mainstream Dr. - Nashville, TN
Why Join Ascension?
Ascension Care Management (ACM) creates customized healthcare solutions for health systems, payers, and employers that stabilize costs, improve outcomes, and enhance the experience for both providers and individuals. Our range of services strive to create a seamless healthcare experience for providers, payers and healthcare leaders by improving access to and removing complexity from the delivery of healthcare.
ACM serves 1.3 million patients across the nation and manages more than 20,000 providers through our clinically integrated networks of providers. ACM helps our customers eliminate stress and uncertainty, allowing them to confidently provide quality, value-based services and solutions. Beyond traditional population health management solutions, ACM offers additional expertise in claims management, care coordination, risk management and safety strategies that allow healthcare leaders to avoid challenges and capitalize on healthcare opportunities.
What You Will Do
As a Provider Network Specialist with Ascension Care Management, you will be responsible for managing tasks aligned with contracting physicians, hospitals, and ancillary providers in multiple geographies, as well as providing internal support to the Network team.
- Identifies and pursues providers to develop a stronger presence within strategic specialties or geographic locations.
- Analyze claims data to ensure that network composition includes an appropriate distribution of provider specialties.
- Work with provider partners to gather all required documents needed to prepare and execute a contract.
- Maintain internal databases with all provider demographic updates and notes on contracting status.
- Manage contract accuracy including validation of provider demographics credentialing and system accuracy prior to submitting contract requests.
- Manage the overall contracting flow with timely follow-up so contracts get completed in a timely fashion.
- Address questions from providers regarding contract language, contract set-up, payment methodology and other processes.
- Assists Provider Network Administrators in planning and implementing regular Network Participation Meetings with senior physician leaders.
- Participate in department projects as needed.
What You Will Need
- High school diploma/GED with 2 years of experience, or Associate's degree, or Bachelor's degree required
- 3 years of provider relations, network management, managed care contracting, or related healthcare experience preferred.
Equal Employment Opportunity
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