Network Operations Representative
HealthSpring 39 reviews - Harlingen, TX

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Develops and maintains positive relationships with physicians, providers, and practice managers within the provider network.

Required Skills

Responsibilities include educating providers and office staff on contracts, policies, and procedures, managing the contracting process, root cause analysis and resolution of problems and issues, managing monthly provider visits and calendar of events, participating in monthly financial review with senior management, building and communicating with internal relationships, preparing material and participating in meetings with providers, provider staff, and/or IPA leadership, and planning, creating, and delivering presentations. Requires at least 70% external travel to network providers. May supervise or provide guidance to others in the department.

For I-SNP program, responsible for lead generation for enrollment of new members through providers. Works with sales to facilitate appointments, presentations, and enrollments.

Required Experience

Minimum Requirements : Bachelor’s degree. At least one year customer service, claims, and/or payor related experience. Proficient at Microsoft Office products and learning reporting applications. Excellent communication skills. For I-SNP program, must maintain a valid insurance license.

Preferred Requirements : BA or Marketing Degree. At least three years experience related experience. Demonstrated knowledge of contracting process, Medicare fee schedules, financial terms, and metrics.

HealthSpring, Inc. is an EEO/AA employer .

About this company
39 reviews
Looking to keep a spring in Grandma's step, HealthSpring provides Medicare Advantage plans and Medicare Part D prescription drug...