Provider Network Specialist jobs in Fort Myers, FL
Provider Network Specialist coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Provider Network Specialist jobs
PRN Nurse Practitioner/ Flex Provider
- Matrix Medical Network
-
Fort Myers, FL
FULL_TIME
- Company DescriptionMATRIX MEDICAL NETWORK is dedicated to helping in the care of Medicare Advantage plan members. Our success comes as the result of our extraordinary people, years of experience, advanced technology and powerful information management capabilities. In partnership with health plans and medical service providers, we are establishing new standards in health care quality, efficiency and effectiveness.Job DescriptionFLEX PROVIDER POSITION SUMMARY: The Flex Provider (fP) provides clinical assessment and care to assigned patients including assessments of health plan members in their homes and in facilities. The responsibilities include: adult/geriatric assessment, medical history, physical exam, medication reconciliation, diagnosis, and health education. Additionally, patient education, communication to the PCP, follow-up facilitated with the PCP, and case management referrals may also be part of any assessment. Clear documentation according to Matrix Medical Network (MMN) guidelines and protocols is required. Flex Providers will use previously acquired skills, education, medical training and experience as a medical professional in performing assessments. In the performance of the assessments, patient safety and well‐being is of the highest priority. Flex Providers are expected to maintain MMN standards for quality and customer service. Accordingly, the assessments performed by Flex Provider will be performed in accordance with currently approved and generally accepted professional medical standards and with MMN policies and procedures. From time to time, MMN will provide to Flex Providers copies of those policies and procedures. Other clinical care services may be required within the NP scope of practice. FLEX PROVIDER RESPONSIBILITIES: • Performs in-depth health risk assessments on all assigned members in patient homes or facilities • Works collaboratively with physicians, case managers, social workers, family members, key care givers and any appropriate ancillary medical personnel as appropriate • Responsible for identifying overall quality improvement activities through assessing and planning health care which is individualized to the member and consistent with Matrix Medical Network policies and protocols • Reviews and interprets the medical and social history of members • Performs appropriate screening procedures for members • Interprets laboratory data, recommends appropriate follow-up, reconciles medications • Refers members to PCP, case management and disease management programs as necessary. • Maintains positive control of all PHI information • Works closely with others within Matrix to create an effective and productive schedule • Is compliant with Matrix training/education requirements, OSHA, State Board of Nursing and other regulatory programs; seeks guidance for compliance-related concerns and adheres to all applicable laws, regulations and Matrix Medical Network policies and procedures QualificationsFLEX PROVIDER REQUIREMENTS: Knowledge, Skills and Abilities: • Must be able to demonstrate computer skills, including use of e-mail and Microsoft office word and excel • Must be able to demonstrate effective written communication skills including but not limited to writing reports and correspondence • Must be able to demonstrate effective verbal communication skills, including but not limited to speaking effectively to members, providers, families and staff and listening to members, providers and families • Demonstrated ability to meet deadlines, and use time effectively and efficiently. Concentrates efforts on priorities • Demonstrated successful experience working in an environment of change. Effectively copes with change and uncertainty; responds and “shifts gears” comfortably • Is dedicated to meeting the expectations and requirements of both external and internal customers, acts with customers in mind • Demonstrated ability to establish and maintain effective relationships with customers, and gain their trust and respect • Uses logical methods to solve problems with effective solutions; looks beyond the obvious for solutions • Is action oriented and sees challenges as opportunities Baseline Clinical Knowledge • Proven ability to perform comprehensive, adult/geriatric physical exam • Demonstrated ability to identify, diagnose and document chronic disease in adults • Demonstrated ability to recognize conditions, characteristics, and behaviors that place seniors at risk • Proven ability to pursue feedback, continuing education and professional development • Ability to effectively reconcile medications • Demonstrated ability to identify and document the needs of clinically complex patients Pertinent Clinical Work Experience which is relevant to Matrix • Must have: Minimum 1 year clinical experience as a Nurse Practitioner in geriatric, adult or family practice setting plus 3 – 5 years relevant RN experience or 2 -3 years Nurse Practitioner experience in geriatric, adult or family practice. Education • Bachelor of Science in Nursing preferred • Master’s Degree required OR commensurate experience and satisfactory completion of NP licensure Licensure/Certifications • Current RN and NP licensure in state of practice • Board certification by AANP or ANCC, in Adult, Family Practice and Geriatrics or Adult-Gerontology Primary Care • Current CPR certification Travel Requirements: Travel required • Must meet company driving standards • Must have valid state driver license and be able to drive a car • Must meet company’s automobile liability insurance standards and provide proof of coverage • Must be able to travel by public transportation, and airplanes • Must be able to independently travel to assigned locations Physical and Psychological Demands: • Requires prolonged sitting • Requires bending, stooping, twisting, kneeling, crouching, crawling and/or stretching from seated or standing positions • Requires eye-hand coordination and manual dexterity sufficient to operate medical equipment, computer tablet, computer keyboard, telephone, copier, calculator and other office equipment • Requires close vision, peripheral vision, and ability to adjust visual focus, hearing and smelling • Must be able to communicate information via telephone or computer • Requires moderate to intense concentration due to complexity of the job • Must be able to lift and/or move up to 75 lbs. • Must be able to observe “Universal Precautions” for blood-borne pathogens and body fluids Additional InformationEqual Opportunity EmployerMatrix Medical Network does not discriminate in practices or employment opportunities on the basis of an individual's race, color, national or ethnic origin, religion, age, sex, gender, sexual orientation, marital status, veteran status, disability, or any other proscribed category set forth in federal or state regulations.The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of the position.
- 1 Month Ago
Referral Specialist
- Healthcare Network
-
Immokalee, FL
FULL_TIME
- Healthcare Network (HCN) is a Federally Qualified Health Center (FQHC) serving as the medical home for patients from birth to geriatric. We provide quality medical, dental and behavioral health servic...
- 24 Days Ago
Medicaid Specialist
- Healthcare Network
-
Naples, FL
FULL_TIME
- Healthcare Network (HCN) is a Federally Qualified Health Center (FQHC) serving as the medical home for patients from birth to geriatric. We provide quality medical, dental and behavioral health servic...
- 1 Day Ago
Purchasing Specialist
- Outdoor Network
-
Lake Placid, FL
FULL_TIME
- DescriptionThe Purchasing Specialist is responsible for a multitude of tasks in the Company’s Purchasing Department that contributes to the overall satisfaction of the Company’s customers. This holder...
- 10 Days Ago
Medical Billing Specialist
- Healthcare Network
-
Naples, FL
FULL_TIME
- Healthcare Network (HCN) is a Federally Qualified Health Center (FQHC) serving as the medical home for patients from birth to geriatric. We provide quality medical, dental and behavioral health servic...
- 4 Days Ago
Loan Specialist
- Farm Credit Network
-
La Belle, FL
FULL_TIME
- It has never been a better time to join Farm Credit of Florida. Come be a part of the talented team of employees supporting our LaBelle branch office. In this role, you will deliver an outstanding cus...
- 19 Days Ago
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0 Provider Network Specialist jobs found in Fort Myers, FL area
Network Analyst
- SharpHeads
-
Cape Coral, FL
- We are looking for a contract/ temporary Network Engineer to work with our client in Cape Coral, Fl. This is an onsite p...
- 4/29/2024 12:00:00 AM
Network Engineer Analyst
- Moten Tate, Inc.
-
Cape Coral, FL
- Job Description Job Description We are looking for a contract/ temporary Network Engineer to work with our client in Cap...
- 4/29/2024 12:00:00 AM
Network Analyst
- Sharpheads
-
Cape Coral, FL
- We are looking for a contract/ temporary Network Engineer to work with our client in Cape Coral, Fl.This is an onsite po...
- 4/29/2024 12:00:00 AM
Applications & Workflow Specialist
- Millennium Physician Group
-
Fort Myers, FL
- Job Description Job Description IT-Applications & Workflow SpecialistMillennium Physician GroupFull Time (Monday-Friday ...
- 4/29/2024 12:00:00 AM
Sr NOC Engineer
- Interop Technologies
-
Fort Myers, FL
- Job Description Job Description PRIMARY RESPONSIBILITIES (include but not limited to): Troubleshoot and manage configura...
- 4/29/2024 12:00:00 AM
IT Systems Administrator
- Coastal IT Consulting, LLC
-
Fort Myers, FL
- Job Description Job Description Company Condition of Employment - We are an equal opportunity employer. Accommodations w...
- 4/29/2024 12:00:00 AM
Tier 1 & 2 IT Support Technician
- Junopi LLC
-
Fort Myers, FL
- Job Description Job Description We are a small IT company looking to add a support technician for onsite & remote custom...
- 4/28/2024 12:00:00 AM
Video Surveillance Network Specialist $30/hr
- Express Employment Professionals
-
Fort Myers, FL
- Job Description Job Description Express Employment Professionals has teamed up with an well-established technology contr...
- 4/27/2024 12:00:00 AM
About Fort Myers, Florida
Fort Myers or Ft. Myers, is the county seat and commercial center of Lee County, Florida, United States. It has grown rapidly in recent years. As of the 2010 census, the city population was 62,298 and in 2017 was estimated at 79,943.
Fort Myers is a gateway to the Southwest Florida region and a major tourist destination within Florida. The winter estates of Thomas Edison ("Seminole Lodge") and Henry Ford ("The Mangoes") are major attractions. The city is named after Colonel Abraham Myers....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$54,848 to $81,999
Fort Myers, Florida area prices
were up 1.5% from a year ago
were up 1.5% from a year ago
What does a Provider Network Specialist do?
Provider Network Specialist in Springfield, MO
As the liaison between provider and the health plan, candidates are tasked with ensuring improved revenue generated and patient quality score.
December 16, 2019
Provider Network Specialist in Stamford, CT
Previous experience in a network development, provider recruitment or provider contracting.
December 04, 2019
Provider Network Specialist in Fort Wayne, IN
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.
January 18, 2020