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Devoted Health logo
Devoted Health

Our mission: to dramatically improve the health & well-being of older Americans by caring for everyone like family

Network Specialist

Network EngineerNetwork EngineerOtherRemoteSeniorTeam 1,001-5,000Since 2017H1B No SponsorCompany SiteLinkedIn

Location

Colorado

Posted

97 days ago

Salary

$65K - $75K / year

Seniority

Senior

3 yrs expEnglish

Job Description

Network Specialist

Devoted Health

• Auditing functions: provider set up in Orinoco (demographic and fee schedules), online search tool, print directory, Periscope reports, claims payment. • Determine root cause of issues and recommend process improvements. • Provide clear analysis and next steps for network team. • Analysis of network grievances, determination of track and trend or provider outreach, complete outreach as needed, prepare monthly reporting. • Contracting to support network adequacy in existing and expansion counties. • Contract processing, to include: obtaining contract signatures, preparing provider rosters, submitting contract load form. • Assistance with Field Network cases, outreach to providers, documentation of resolution. • Evaluate participation requests against network need, current contractual relationships, expansion efforts, access to care. • Make recommendations to management. • Contract as needed. • Respond accordingly to providers. • Assist network managers with monthly JOC meeting preparations, research outliers in financial reports, audit reports for accuracy, assist with follow up items from meetings.

Job Requirements

  • 3+ years of direct provider interaction
  • 3+ years healthcare experience with medicare advantage or other relevant experience.
  • Proven track record of detail oriented work
  • Ability to navigate Google or MS Suite of products.
  • Experience in claims research, provider set up, root cause analysis, process improvement.

Benefits

  • Employer sponsored health, dental and vision plan with low or no premium
  • Generous paid time off
  • $100 monthly mobile or internet stipend
  • Stock options for all employees
  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
  • Parental leave program
  • 401K program
  • And more....

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