VNS Health
Network Management Representative, South Asian Market
VNS Health, New York, New York, us, 10261
OverviewManages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision. Bilingual Urdu or Bengali required.
Compensation:$30.71 - $38.41 HourlyWhat We Provide:Referral bonus opportunitiesGenerous paid time off (PTO), starting at
20 days
of paid time off and 9 company holidaysHealth insurance plan for you and your loved ones, including Medical, Dental, Vision, Life, and DisabilityEmployer-matched retirement saving fundsPersonal and financial wellness programsPre-tax flexible spending accounts (FSAs) for healthcare and dependent careGenerous tuition reimbursement for qualifying degreesOpportunities for professional growth and career advancementInternal mobility, CEU credits, and advancement opportunitiesInterdisciplinary network of colleagues through the VNS Health Social Services Community of ProfessionalsWhat You Will Do:Manage all provider contracts in designated territory, including recruitment, credentialing, recredentialing, and relationship maintenance through regular visits and ongoing contact with existing and potential providers.Prepare materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.Collaborate with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.Monitor contract performance of network providers and serve as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.Coordinate provider site visits, as needed.Coordinate and attend meetings to serve as a resource and address provider issues.Update and maintain provider manuals with current Health Plan policies and procedures.Update and proof provider directories.Assist providers in triaging billing and claims disputes.Participate and collaborate with Compliance on Department of Health and internal audits.Participate in special projects and perform other duties as assigned.
Qualifications:Licenses and Certifications:Driver's license required.
Education:Bachelor's Degree or equivalent related work experience, preferably in a health care setting required.
Work Experience:Minimum three years health care experience required. Knowledge of government programs, including Medicare and Medicaid preferred. Prior experience in Provider Relations preferred.#J-18808-Ljbffr
Compensation:$30.71 - $38.41 HourlyWhat We Provide:Referral bonus opportunitiesGenerous paid time off (PTO), starting at
20 days
of paid time off and 9 company holidaysHealth insurance plan for you and your loved ones, including Medical, Dental, Vision, Life, and DisabilityEmployer-matched retirement saving fundsPersonal and financial wellness programsPre-tax flexible spending accounts (FSAs) for healthcare and dependent careGenerous tuition reimbursement for qualifying degreesOpportunities for professional growth and career advancementInternal mobility, CEU credits, and advancement opportunitiesInterdisciplinary network of colleagues through the VNS Health Social Services Community of ProfessionalsWhat You Will Do:Manage all provider contracts in designated territory, including recruitment, credentialing, recredentialing, and relationship maintenance through regular visits and ongoing contact with existing and potential providers.Prepare materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.Collaborate with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.Monitor contract performance of network providers and serve as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.Coordinate provider site visits, as needed.Coordinate and attend meetings to serve as a resource and address provider issues.Update and maintain provider manuals with current Health Plan policies and procedures.Update and proof provider directories.Assist providers in triaging billing and claims disputes.Participate and collaborate with Compliance on Department of Health and internal audits.Participate in special projects and perform other duties as assigned.
Qualifications:Licenses and Certifications:Driver's license required.
Education:Bachelor's Degree or equivalent related work experience, preferably in a health care setting required.
Work Experience:Minimum three years health care experience required. Knowledge of government programs, including Medicare and Medicaid preferred. Prior experience in Provider Relations preferred.#J-18808-Ljbffr