Top 114 Director of network operations Jobs in Edmond, Ok

Managed Care Specialist
LifeCare Health Services —Oklahoma City, OK
- $22.65 - $39.89 an hour
- Full-time
- Hybrid work
- 5 years
- Office
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
Board Certified Behavior Analyst (BCBA) - Edmond, OK (Hybrid)
BlueSprig —Edmond, OK
- $85,000 - $111,000 a year
- Hybrid work
- Clinic
- Children
- Pediatrics
- Paid holidays
- Dental insurance
Quick Apply
MRI Tech
INTEGRIS Health —Oklahoma City, OK
- Full-time
- Hospital
- BLS Certification
- English
- Health insurance
- Paid time off
Quick Apply
Director of Nursing
OKLAHOMA RECOVERY CENTER LLC —Oklahoma City, OK
- $110,000 a year
- Full-time
- CPR Certification
- Nursing
- RN License
Quick Apply
1d
RN Charge - Sterile Processing
INTEGRIS Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
Cyber Systems Engineer (Principal or Senior Principal Level)
Northrop Grumman —Oklahoma City, OK
- $122,800 - $184,200 a year
- Overtime
- Bachelor of Science
- Master's degree
- Analysis skills
- Paid holidays
- Disability insurance
Cyber Systems Engineer (Engineer or Principal Engineer Level)
Northrop Grumman —Oklahoma City, OK
- $75,100 - $139,900 a year
- Overtime
- Bachelor of Science
- Master's degree
- Bachelor's degree
- Paid holidays
- Disability insurance
Director of Network Operations
The State of Oklahoma —Oklahoma County, OK
- Up to $140,000 a year
- Extended hours
- PMP
- Office
- Ability to lift 50 pounds
- Paid holidays
8d
Director of Program Integration and Impact
Latino Community Development Agency —Oklahoma City, OK
- Full-time
- Spanish
- 5 years
- English
Quick Apply
Operations Director
Inner Circle Autism Network —Oklahoma City, OK
- $60,000 - $70,000 a year
- Extended hours
- Clinic
- Ability to lift 50 pounds
- Bachelor's degree
- Paid holidays
- Disability insurance
Quick Apply
Senior Director Engineering Operations
Dobson Technologies —Oklahoma City, OK
- Full-time
- 5 years
- Residential
- Continuous improvement
Quick Apply
12d
Utilities ERCS Principal Director
Accenture —Oklahoma City, OK
- $150,900 - $434,000 a year
- Full-time
- Oracle
- 11+ years
- Bachelor's degree
- Paid holidays
- Disability insurance
14d
Director, Supplier Performance & Relationship Management
Cushman & Wakefield —Oklahoma City, OK
- $131,750 - $155,000 a year
- Full-time
- 5 years
- Master's degree
- Organizational skills
- Health savings account
- Disability insurance
Quick Apply
Director Network Engineering
Dobson Technologies —Oklahoma City, OK
- Full-time
- Computer science
- Computer Science
- 5 years
Quick Apply
12d
Senior Regional EHS Manager
Amazon.com Services LLC —Oklahoma City, OK
- $126,700 - $246,400 a year
- Weekends as needed
- 7 years
- Up to 50% travel
- Writing skills
- AD&D insurance
- Health insurance
Technology Strategist
University of Oklahoma —Oklahoma City, OK
- Weekends as needed
- Background check
- System design
- Mid-level
Dir System Labor Productivity and Optimization
INTEGRIS Health —Oklahoma City, OK
- CPA
- Office
- Finance
- Health insurance
- Paid time off
Quick Apply
Life Sciences MedTech R&D, Management Consulting Principal Director
Accenture —Oklahoma City, OK
- $150,900 - $434,000 a year
- Full-time
- Travel
- US work authorization
- Military encouraged
- Paid holidays
- Disability insurance
9d
Director, Construction Management
Aligned Data Centers, LLC —Oklahoma City, OK
- $190,000 - $230,000 a year
- Full-time
- Construction site
- Bachelor of Science
- 11+ years
- Paid holidays
- Disability insurance
Quick Apply
6d
Director of Systems Integration, RN
Solara Surgical Partners —Oklahoma City, OK
- From $90,000 a year
- Full-time
- Nursing
- Surgery
- RN License
- Health insurance
- Dental insurance
Quick Apply
2d

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Managed Care Specialist

LifeCare Health Services -
Oklahoma City, OK

Quick Apply

Job Details

Full-time
$22.65 - $39.89 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Term negotiation
Managed care organization experience
Provider enrollment for medical credentialing
CMS
Contract management experience in healthcare
CMS regulatory compliance
Health insurance knowledge
NCQA standards

Full Job Description

Job Title:

Managed Care Specialist

Reports To:

Senior Director Contracting and Payor Relations

Location:

Remote, Hybrid

FLSA Status:

Exempt

Job Summary:

The Managed Care Specialist is a key role responsible for managing and coordinating credentialing and provider enrollment activities for the LifeCare Value Network (LVN) members and other providers who may contract with LifeCare for managed care and provider enrollment consulting services. This individual will assist in the development of a centralized credentialing program, including the exploration and execution of delegated credentialing agreements.

In addition to credentialing, this position supports the Managed Care leadership team in reviewing payer contracts, evaluating contract language, resolving provider relations issues, Joint Operation Committee Meetings with payers and LifeCare and our members, and monitoring the operational performance of managed care agreements.

Essential Responsibilities:

Credentialing & Provider Enrollment

Assist with the design and implementation of a centralized credentialing and provider enrollment program for LVN.
Assist in the process of evaluating, negotiating, and executing delegated credentialing agreements with health plans.
Ensure compliance with National Committee for Quality Assurance (NCQA), and payer-specific standards and timelines.
Collaborate with LVN members and clients to onboard new providers and maintain credentialing files and rosters.
Develop and implement workflows and policies for credentialing and enrollment functions.

Shared Services Development

In collaboration with leadership, build a scalable shared services model for credentialing and enrollment across all LifeCare members and clients.
Standardize processes and identify automation opportunities to improve efficiency and turnaround time of providers’ enrollments.
Develop service-level agreements and performance metrics for the credentialing shared services offering.

Managed Care Operations Support

Support contract lifecycle management including review of payer contract language, operational terms, and reimbursement schedules.
Collaborate with Managed Care leadership on strategy, negotiation preparation, and payer relationship management.
Resolve escalated provider issues related to credentialing, contracting, and enrollment in collaboration with payers and internal stakeholders.
Maintain a detailed understanding of contract operational performance and identify opportunities for improvement.

Required Qualifications:

Bachelor’s degree in Healthcare Administration, Business, or related field preferred or equivalent experience.
Minimum 5 years of experience in provider enrollment and credentialing.
Prior experience in a managed care environment within a health system or payer organization.
Strong knowledge of NCQA, Centers for Medicare & Medicaid Services (CMS), and commercial payer credentialing and enrollment standards.
Experience negotiating or managing delegated credentialing agreements.
Proficient in credentialing software systems and managed care data tools.

Key Competencies:

Strategic Thinking: Ability to create long-term plans and scalable systems across a network.
Problem Solving: Strong analytical skills to identify and resolve complex enrollment, credentialing, and contract issues.
Communication: Excellent verbal and written communication skills with the ability to work across diverse teams.
Collaboration: Experience working with cross-functional teams and external partners to drive shared goals.
Leadership: Ability to lead initiatives and influence decision-making across an organization.

Work Environment and Physical Requirements:

Typical office environment; remote.
Occasional travel to LifeCare member locations for program development, training, or issue resolution.

Pay: $22.65 - $39.89 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Application Question(s):

Are you located in Oklahoma?

Work Location: Hybrid remote in Oklahoma City, OK 73112

Quick Apply

Refine Your Search

director of network operations jobs in edmond, ok

Managed Care Specialist

Board Certified Behavior Analyst (BCBA) - Edmond, OK (Hybrid)

MRI Tech

Director of Nursing

RN Charge - Sterile Processing

Cyber Systems Engineer (Principal or Senior Principal Level)

Cyber Systems Engineer (Engineer or Principal Engineer Level)

Director of Network Operations

Director of Program Integration and Impact

Operations Director

Senior Director Engineering Operations

Utilities ERCS Principal Director

Director, Supplier Performance & Relationship Management

Director Network Engineering

Senior Regional EHS Manager

Technology Strategist

Dir System Labor Productivity and Optimization

Life Sciences MedTech R&D, Management Consulting Principal Director

Director, Construction Management

Director of Systems Integration, RN

I want to receive the latest job alert for director of network operations in edmond, ok

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