MiamiRecruiter Since 2001
the smart solution for Miami jobs

Manager, Provider Network Operations

Company: AvMed
Location: Miami
Posted on: April 10, 2021

Job Description:

Embrace better opportunities.Are you passionate about health, happiness and helping others? So are we. We're committed to helping our health plan Members live a happy and healthy lifestyle, and we believe that it starts here first, with our Associates.At AvMed, we provide the tools and opportunities to enhance, expand, and support each Associate's personal and professional growth. From tuition reimbursement to exercise classes in the office, embrace a better career with AvMed and join our team!Position: Manager, Provider Network OperationsScope of position: The Provider Network Operations Manager shall be responsible for the management of the Provider Network Operations department and the functions it provides in support of AvMed's Unit Cost Contracting and Value Based Relationship strategies. These functions include but are not limited to: provider servicing; facility and ancillary data management; contract life-cycle management and maintenance; provider roster management; contract process improvement and implementation; analytical reporting; claims reconciliation, and other continuous improvement activities aimed towards enhancing the provider and member experience. The Provider Network Operations department shall be governed as the liaison between the Network Division (Unit Cost Contracting and Value Based Relationships) and the rest of the organization (Credentialing, PDM, Configuration, etc.) The Manager of Provider Network Operations will provide input to strategic decisions that affect the functional area of responsibility.We offer:Competitive SalariesComprehensive Benefits: Medical Plans, Health Savings Account, Dental, Vision, and more...Paid Time Off, Company Paid Holidays, Paid Time Off Cash-In401(k)plan with matching contributions, Tuition Assistance, Associate DiscountsYou have:Bachelor's degree required. Masters preferred.6 to 10 years of HMO management experience in the field of provider contracting and network management with an understanding and knowledge of provider data management, hospital & ancillary contracting and/or value-based contracting.Basic knowledge of provider data system configuration and credentialing.Experience with, or knowledge of, claims payment processes preferred.Needs to have managed a team within a health plan for at least 5 years.You May Also Have:Excellent verbal and written communication skillsProficient in Microsoft Word, Outlook, Excel, and PowerPointAble to create comprehensive Excel data spreadsheets, work with Excel formulas, and create reportsProficient in Microsoft Windows environmentBasic claims payment system knowledgeWell organized, with the ability to handle multiple and competing prioritiesIs adept at aligning resources to achieve key objectivesFull understanding of the business, regulatory and competitive environmentsMaintains awareness of industry trends in the market and at the national levelEQUIPMENT SKILLS:KeyboardAdvanced knowledge of personal computers and softwareEnvironment:At AvMed, you'll find a family. Our Associates love all the opportunities for advancement, the flexible work environment and team activities. We also encourage our Associates to embrace a life rich in what matters most - health and happiness. We call it beingWELLfluent. Join AvMed. Join theWELLfluent!Location: AvMed is located near the internationally popular Dadeland Mall, adjacent to a wide variety of residential neighborhoods ranging from pedestrian-friendly urban-style communities to beautiful green suburbs. It is also easy to access through public transportation - a short walk from the Metrorail - and major highways so all that Miami has to offer is within reach.AvMed is a tobacco/drug free workplace, EOE

Keywords: AvMed, Miami , Manager, Provider Network Operations, Executive , Miami, Florida

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Executive Jobs

Vice President of Brand Management
Description: 54 of your waking br hours are spent at work. Make them count Vice President of Brand Management Sales
Company: Autocar, LLC
Location: Miami
Posted on: 04/11/2021

Assistant Property Manager
Description: Ref ID: 01754123Classification: BookkeeperCompensation: DOEAccountemps has partnered with an esteemed firm to bring an experienced Bookkeeper onto their rapidly-growing team. This position requires strong (more...)
Company: Robert Half
Location: Miami
Posted on: 04/11/2021

Director of Partnerships
Description: Director of Partnerships br Location: Miami, FL br br Who You'll Work For br br REEF's mission is to connect the world to your block. br br We transform underutilized urban spaces into neighborhood (more...)
Company: REEF
Location: Miami
Posted on: 04/11/2021

Product Manager
Description: You Lead the Way. We've Got Your Back. br br At American Express, we know that with the right backing, people and businesses have the power to progress in incredible ways. Whether we're supporting (more...)
Company: American Express
Location: Dania
Posted on: 04/11/2021

Director Materials and Planning
Description: Danaher Corporation Director Materials and Planning in Miami , Florida Wondering what's within Beckman Coulter Take a closer look. Join a team where you can be heard, be supported, and always be yourself. (more...)
Company: Danaher Corporation
Location: Miami
Posted on: 04/11/2021

Area Talent Acquisition Manager, Miami
Description: Opportunity.Create.Publishing.ThirdPartyJobBoards.MoreInfoModal.Title OpportunityDetail.CompanyInformation.Locations A global tribe of individuals, partners and progressives, devoted to creating extraordinary (more...)
Company: Morgans Hotel Group
Location: Miami
Posted on: 04/11/2021

Salon Manager - Frenchman's Crossing
Description: Salon Manager Got shears and a winning attitude Have a yearning to earn and a desire to hire and support other stylists Then let's talk Maybe you're a stylist who wants more responsibility,
Company: Great Clips
Location: North Palm Beach
Posted on: 04/11/2021

Deputy Public Works Director
Description: Town of Juno Beach 13 br Deputy Public Works Director Full Time Position 13 br Hours of Work: Monday Friday 7:30 am 4 pm 13 br Pay Range: 53,634 83-133 13 br Application Deadline: (more...)
Company: Town OF Juno Beach
Location: North Palm Beach
Posted on: 04/11/2021

Physician / Pain Management / Maryland / Permanent / Medical Doctor Pain Managment Job
Description: Due to overwhelming demand and patient waiting list we are expanding to a second
Company: Confidential
Location: North Palm Beach
Posted on: 04/11/2021

Veterans Preferred - Tax Manager - Business Tax
Description: Military Veterans are Encouraged to Apply. As a Tax Manager for RSM you will be responsible for the following job duties which are focused around three core concepts Technical Quality Expertise, People (more...)
Company: RSM
Location: West Palm Beach
Posted on: 04/11/2021

Log In or Create An Account

Get the latest Florida jobs by following @recnetFL on Twitter!

Miami RSS job feeds