Network Management Specialist, Value Based Program

Albuquerque NM 87113

Job Description

Responsible for maintaining and development of practitioners, facilities and other behavioral health service providers in the behavioral health directory per NCQA and CMS requirements. Coordinates with Network Development and Network Managers to ensure quality and accurate information. Serves as a communication link between contracted providers and the organization. Provides input on strategic plan for the development of network participation in value-based initiatives, and conducts focused recruitment activities.

Maintains current availability and demographic information for providers by conducting outbound calls and mailings to contracted providers.
- Ensures completed provider demographic information is loaded into the management tool and processed in a timely manner.
- Maintains recruitment tracker updates, ensuring accurate reporting of the network build progress for value-based programs.
- Assists Network Managers with the identification of available providers and analysis of available provider data.
- Maintains provider relationships and participates with Network team to coordinate outreach and recruitment

- Supports processes that address provider complaints, claims, contracting, credentialing and other problems requiring follow-up and resolution.

- Travel in-state may be required for meetings

- Other duties as assigned.

General Job Information

Title

Network Management Specialist, Value Based Program

Grade

20

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

6/19/2019

Date Requisition Created

6/18/2019

Work Experience

Network, Provider Relations

Education

Bachelors: Business Administration

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Previous experience in a network development, provider recruitment or provider relations.

Bachelor's Degree in Business Administration

  •  Knowledge of National Committee for Quality Assurance (NCQA) requirements. 
  • Ability to work independently and prioritize activities. 
  • Intermediate knowledge of Microsoft Office Suite, specifically Excel. 
  • Strong presentations skills using PowerPoint. 
  • Minimum of 2 years experience in network management - related position/field. 
  • Ability to travel locally and state-wide as needed.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.