Manager of Provider Operations

Job Summary

A company is looking for a Manager of Provider Network Operations.

Key Responsibilities

• Maintain knowledge of processing rules, contractual guidelines, and operational procedures
• Manage day-to-day activities of the Provider Reimbursement department and supervise staff performance
• Analyze provider reimbursement and update codes and fee schedules for accurate payments

Required Qualifications

• Three to five years of experience in healthcare or related state policy, specifically with Medicaid requirements
• Bachelor's Degree or equivalent experience/education
• Demonstrated ability to coordinate activities across functional areas
• Knowledge of healthcare services delivery and medical billing principles
• Experience with healthcare claims payment configuration processes and their impact on network operations