Top 683 Program specialist groups Jobs in Austin, Tx

IPA, Network Provider Specialist [HOUSTON]
Nutex Holdco LLC —Austin, TX
- Full-time
- Microsoft Word
- Microsoft Access
- Marketing
- Health insurance
- Dental insurance
IPA, Network Provider Specialist [DALLAS]
Nutex Holdco LLC —Austin, TX
- Full-time
- Microsoft Word
- Microsoft Access
- Marketing
- Health insurance
- Dental insurance
Human Resources Generalist
Hyde Park Church —Austin, TX
- $58,300 - $60,000 a year
- Full-time
- Background check
- Mid-level
- Office
- Paid jury duty
- Health insurance
Quick Apply
Physician (Physical Medicine & Rehabilitation (PM&R))
Austin Regional Clinic —Austin, TX
- Full-time
- BC/BE
- Physical & Rehabilitation Medicine
- Outpatient experience
- Disability insurance
- Health insurance
Quick Apply
Disability Specialist II
Health & Human Services Comm —Austin, TX
- $4,594.16 - $5,094.16 a month
- Weekends as needed
- Writing skills
- Data analysis skills
- Adults
- Health insurance
- Opportunities for advancement
Quick Apply
Early Intervention Specialist
Easter Seals Central Texas —Austin, TX
- Full-time
- Spanish
- Experience working with individuals with disabilities
- English
- 403(b) matching
- Disability insurance
Quick Apply
Capitol Visitor Center (CVC) Tour Guide - 3 positions
STATE PRESERVATION BOARD —Austin, TX
- $16 an hour
- Part-time
- Background check
- Ability to walk for extended periods
- Research
Quick Apply
Program Specialist - Groups
YMCA of Central Texas —Cedar Park, TX
- $17 - $19 an hour
- Part-time
- Background check
- 18 years or older
- Pass drug screening
Quick Apply
SVP Treasury Management
Horizon Bank —Austin, TX
- Full-time
- Customer service
- 5 years
- Office
- Wellness program
- AD&D insurance
Quick Apply
SVP Treasury Management
Horizon Bank —Austin, TX
- Full-time
- Customer service
- 5 years
- Office
- Wellness program
- AD&D insurance
Quick Apply
Pricing and Proposals Specialist
Pioneer Golf —Austin, TX
- $50,000 - $60,000 a year
- Full-time
- Background check
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
11d
AI Transformation Lead
Confidential —Austin, TX
- $160,000 - $200,000 a year
- Full-time
- Hybrid work
- Background check
- Data analysis skills
- Office
- Health insurance
- 401(k)
Quick Apply
Critical Infrastructure Compliance Specialist
Pedernales Electric Cooperative —Cedar Park, TX
- Overtime
- Hybrid work
- Customer service
- Computer literacy
- Research
Membership Services Specialist
Texas Association of Community Health Centers —Austin, TX
- Full-time
- Hybrid work
- Spanish
- Microsoft Excel
- Writing skills
- Health insurance
- Dental insurance
Quick Apply
2d
Sales and Leasing Consultant - Mercedes-Benz of Austin
CONTINENTAL AUTO GROUP —Austin, TX
- $21 an hour
- Full-time
- 18 years or older
- Spanish
- Clean driving record
- Paid training
- Paid parental leave
Leasing Specialist
The NRP Group —Austin, TX
- Weekends as needed
- Mid-level
- Reliable transportation
- Paid parental leave
- Paid holidays
Quick Apply
CT Technologist Lead Pflugerville Free Standing ED
St. David's North Austin Medical Center —Austin, TX
- Weekends only
- Surgery
- Adults
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Community Assistant
The NRP Group —Austin, TX
- Full-time
- Mid-level
- Apartments
- 1 year
- Paid parental leave
- Paid holidays
Quick Apply
Community Manager
The NRP Group —Austin, TX
- Full-time
- Mid-level
- Apartments
- 1 year
- Paid parental leave
- Paid holidays
Quick Apply
Lead Veterinarian
New Hope Animal Hospital —Cedar Park, TX
- $130,000 - $150,000 a year
- Full-time
- Senior level
- Leadership
- 2 years
- Paid parental leave
- Disability insurance
Quick Apply
9d

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IPA, Network Provider Specialist [HOUSTON]

Nutex Holdco LLC -
Austin, TX

Apply Now

Job Details

Full-time

Benefits

Health insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
Life insurance

Qualifications

Vendor relationship building
Contract management experience in healthcare
Bachelor's degree
Health insurance knowledge
Direct contracting

Full Job Description

IPA, Network Provider Specialist [HOUSTON]

The IPA, Provider Network Specialist manages the physician network by developing and maintaining the assigned IPA/Medical Group. This individual provides service and education to network physicians/providers and achieves company targets by implementing network improvement plans. The representative offers professional work and is responsible for performing activities pertaining to IPA Provider Network Specialist. This job includes traveling to provider offices and working under general supervision. Positions at this level are assigned a broad range of duties in the occupation. The representative uses judgment in selecting appropriate guidelines and applying general policies and procedures.

ROLE TYPE: On the road

RESPONSIBILITIES

Completes new provider orientation for all applicable product lines.
Conducts provider group meetings to review monthly/quarterly data and outcomes.
Responsible for meeting minutes and follow-up on 'TO DO' items identified at meetings.
Conduct site visits to service providers, resolve issues, educate staff and providers on policies, and collect credentialing information.
Conduct site visits to service providers and educate staff and providers on submitting Risk Adjustment Factor Data and HEDIS information.
Maintains relationships with contracted HMOs to implement amendments to DOFR, delegation, policy, and procedures.
Returns all routine calls from providers within 24 hours to establish consistent and robust relationships with provider offices.
Provide oversight on inquiries and claims issues and follow up with providers to ensure problems have been resolved.
Maintains provider office tools, including provider manual.
Supports regional Network Improvement Plan targets by providing utilization reports, ER contingencies, Frequent Flier Reports, and other analytics available to improve /maintain regions.
Identifies network gaps and completes contracts for PCP, Specialist, and Ancillary networks with in-depth knowledge of different fee schedules (Medicare/Medical/ASP/AWP).
Identifies new cost-saving possibilities through working with various committees, such as UM and Claims.
Understands and explains risk contracts (shared risk/entire risk).
Strategizes for membership growth and retention.
Provide training, mentoring, and guidance to new representatives.
Works on special projects as assigned or directed.

QUALIFICATIONS

Knowledge of MS Office: Word, Excel, PowerPoint, Access Database.
Knowledge of MS Provider relations/customer service strategies.
Knowledge of MSO-VL and MMSE programs and services: Authorizations, Claims, Credentialing encounters, RAF, Star Ratings, IS/IR, etc.
Knowledge of Network development strategies and Provider Relations experience or similar background.
Knowledge of current MSO-VL and MMSE geo-access requirements.
Effective and efficient oral and written communication skills.
Knowledge of County provider demographics.
Skills in negotiating contract language and rate structures.
Skills to provide training and technical assistance to contracted providers.
Skills to evaluate and assess provider network to determine gaps and services needed.
Skills to identify and develop new providers to ensure accessibility.
Skills to monitor contract performance through site visits and data analysis.
Skills to facilitate contracted provider meetings.
Ability to represent the department or division professionally.
Ability to establish and maintain effective working relationships with contracted and potential providers.
Ability to resolve provider inquiries or requests promptly.

REQUIREMENTS

Bachelor's Degree in Marketing or Business Administration
Minimum of 2 years experience in Network Management within a managed care environment, health plan, or significant medical group administration.

BENEFITS:

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

Apply Now

Refine Your Search

program specialist groups jobs in austin, tx

IPA, Network Provider Specialist [HOUSTON]

IPA, Network Provider Specialist [DALLAS]

Human Resources Generalist

Physician (Physical Medicine & Rehabilitation (PM&R))

Disability Specialist II

Early Intervention Specialist

Capitol Visitor Center (CVC) Tour Guide - 3 positions

Program Specialist - Groups

SVP Treasury Management

SVP Treasury Management

Pricing and Proposals Specialist

AI Transformation Lead

Critical Infrastructure Compliance Specialist

Membership Services Specialist

Sales and Leasing Consultant - Mercedes-Benz of Austin

Leasing Specialist

CT Technologist Lead Pflugerville Free Standing ED

Community Assistant

Community Manager

Lead Veterinarian

I want to receive the latest job alert for program specialist groups in austin, tx

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