How to Become a Provider Network Specialist

The Provider Network Consultant is responsible for serving as a liaison between DHP’s provider community and internal departments in effectively identifying and resolving issues received from clinical, business office or prior-authorization staff.  This position can be located in our Madison or Waukehsa office.

Manages and resolves provider contract, operational and other organizational needs or concerns for DHP’s network of contracted providers for all product lines across all types of providers including, but not limited to, primary care sites, specialty care providers and hospital facilities.

Identifies and works with the provider to address education needs relative to DHP’s new product lines/expansions, utilization management, claims submission, and back-end issues resolution requirements of each assigned provider’s contract.

Creates, maintains, and ensures the integrity of the provider data in DHP’s multiple claims payments systems and provider interface programs.

In this position, employees will be expected to perform benefits analysis and create reports on provider performance to support the needs of the analysis found.

Excellent understanding of network protocols and network technologies, including Layer 2/Layer 3 switching and routing.

The purpose of this position is to help build and maintain a saleable and compliant provider network as part of the Network Management (NM) Administration team.

Responsible for the daily operation of Provider Network Associates and Representatives.

Requires a BA/BA degree; 2 years of business analysis, process improvement, project management, network management or related experience; or any combination of education and experience, which would provide an equivalent background.  3-5 years of experience in provider contracting, provider network development, provider network management preferred.

The port of Hamburg, leading logistics companies and a thriving digital economy make Hamburg an ideal location for Equinix’s mission to drive digitisation locally – connecting companies, partners, network service providers, and cloud providers.

Assisted members to understand their medical plan, benefits and to choose medical providers and locations available to them.

Excellent understanding of network protocols and network technologies, including Layer 2/Layer 3 switching and routing.

Skills in establishing and maintaining effective work relationships with staff, providers and other employees throughout the organization.

Provider data management experience and basic knowledge of provider agreements and amendments as it applies to provider changes.

Networking Sales Specialist Feb 22 Full-Time, Partial Remote Job Candidates need to be able to work in the City or State specified  Philadelphia, PA.