Field Network Coordinator
Under direction of Field Network Director/Manager, the incumbent is responsible for the support of all activities related to developing and maintaining the physician, practitioner, group, and/or facility, MPPS and organization services delivery system in small to mid-size market defined by membership, number of providers in delivery system, number of business operating units and lines of business. Interacts with all areas of organization at the RSC and Magellan-wide to coordinate network management and network administration responsibilities.
Conducts and coordinates contracting and amendment initiatives.
Provides issue resolution and complex trouble shooting for providers.
Conducts provider education and provider relation activities, providing necessary written materials.
Conducts administrative provider site visits and coordinates report development and completion according to contractual requirements or adhoc requests.
Coordinates PPRC activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality of care issues and complaints against providers.
Conducts and manages ongoing audits of provider compliance with Magellan policies and procedures as well as contractual obligations for multiple customers. Develops work plans to address audit requirements.
Works with management to draft, clarify and recommend changes to policies which impact network management.
- Under direction of Field Network Director/Manager, assesses network needs, analyzes network composition, and using organization databases, application of regulatory requirements, accreditation entities and other resources, recruits individual, group and/or organizational providers to meet network adequacy standards and assure quality network.
Experience: Minimum of 1 year experience in behavioral healthcare related field.
An equivalent combination of experience and education is acceptable.
Computer Skills: Intermediate knowledge of Microsoft Office Software necessary including Excel, Project, Word, Access, and Power Point.
Ability to travel by auto and air required, knowledge of NCQA requirements. Ability to work independently and prioritize activities.
Minimum of 1 year in giving presentations
Experience: Previous experience in a Network Development Department, previous experience in provider recruitment and previous experience in provider contracting.
Knowledge, Skills, Abilities: Knowledge of Magellan Network Systems.
NE-Lincoln NE-1221 N Street
1221 N Street (NE01)
1221 N Street
Magellan Health Services is a leading specialty health care management organization with expertise in managing behavioral health, radiology and specialty pharmaceuticals, as well as public sector pharmacy benefits programs. We deliver innovative solutions to make a positive impact on the cost and quality of health care, keeping the best interests of the people we serve at the center of our decision-making. The breadth of our offerings, depth of expertise, clinical excellence and smart, talented employees is what makes us unique.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment where we value professional growth and development, total health and wellness, rewards and recognition and employee unity. Magellan is a place where you can thrive.
Magellan Health Services - 16 months ago
Magellan Health Services has charted its course to become one of the largest managed behavioral health care companies in the nation. The...