Top 391 Network specialist Jobs in New York, Ny

Provider Engagement Network Specialist - Hybrid
EmblemHealth —New York, NY
- $56,160 - $99,360 a year
- Microsoft Excel
- Mid-level
- 3 years
Provider Network Specialist
US Family Health Plan @ SVCMC, Inc. —New York, NY
- $70,000 - $75,000 a year
- Full-time
- 5 years
- Office
- High school diploma or GED
- Commuter assistance
- Paid holidays
Quick Apply
Network Support Specialist
Kyndryl —New York, NY
- $79,920 - $182,520 a year
- Full-time
- Remote
- 5 years
- Mid-level
- Scripting
- Health insurance
- Dental insurance
Executive IT Support Specialist
The Community Preservation Corporation —New York, NY
- $90,000 - $115,000 a year
- Weekends as needed
- Hybrid work
- Microsoft Outlook
- Mid-level
- Office
- Paid jury duty
- Commuter assistance
IT Specialist
Osborne Association Inc —Brooklyn, NY
- $31.54 - $32.49 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
- 403(b) matching
- Health insurance
6d
IT Support Specialist I
Weill Cornell Medicine —New York, NY
- $33.30 - $37.69 an hour
- Weekends as needed
- Mid-level
- Windows
- High school diploma or GED
Information Technology - IT Service Specialist
Aritzia —New York, NY
- $50,000 - $150,000 a year
- Full-time
- Mid-level
- Office
7d
Desktop Support Technician
DEPARTMENT OF FINANCE —Manhattan, NY
- $95,233 - $112,346 a year
- Full-time
- Computer Science
- Mid-level
- Office
- Work from home
- Loan forgiveness
IT Logistics Specialist
Hermès Paris —Manhattan, NY
- $80,000 - $90,000 a year
- Full-time
- Bachelor's degree
- Warehouse
- Warehouse experience
- Profit sharing
- Paid parental leave
2d
Lead Technician - Corporate Services
NYU Langone Health —New York, NY
- $101,493.51 - $115,951.87 a year
- Weekends as needed
- Hospital
- Bachelor of Science
- System design
- Wellness program
School Technology Specialist - NYC
Inspiroz —New York, NY
- $58,000 - $75,000 a year
- Full-time
- Mid-level
- Windows
- Bachelor's degree
Quick Apply
Computer Support Technician II
New York University —New York, NY
- $38.10 an hour
- Full-time
- Mid-level
- High school diploma or GED
- University
Clinical Business Analyst I
NYC Health + Hospitals —New York, NY
- $62,861 - $70,000 a year
- Full-time
- Mid-level
- Master's degree
- Bachelor's degree
- Commuter assistance
- Paid holidays
System Support Specialist - Full Time; 9171-318-N
Catholic Charities Brooklyn and Queens —Brooklyn, NY
- $70,000 - $78,400 a year
- Weekends as needed
- Computer science
- Computer Science
- Adults
- Paid holidays
- Health insurance
Quick Apply
14d
Cyber Risk Analyst
TECHNOLOGY & INNOVATION —Brooklyn, NY
- $75,000 - $91,566 a year
- Weekends as needed
- Mid-level
- Office
- Analysis skills
- Loan forgiveness
Tenant Relocation Specialist
AECOM —New York, NY
- $105,000 - $125,000 a year
- Full-time
- Mid-level
- SQL
- Bachelor's degree
- AD&D insurance
- Employee stock purchase plan
SENIOR LAN SPECIALIST
Agency HRA/DEPT OF SOCIAL SERVICES —Brooklyn, NY
- $99,209 - $114,090 a year
- Full-time
- Computer Science
- Office
- Master's degree
- Loan forgiveness
- Food provided
Desktop Support Specialist
Cornerstone Research —New York, NY
- $61,200 - $78,500 a year
- Weekends as needed
- Hybrid work
- Customer service
- Mid-level
- Office
- Paid time off
- Parental leave
Technical Support Specialist
SLR Consulting —New York, NY
- $80,000 - $85,000 a year
- Full-time
- Microsoft Outlook
- Mid-level
- Windows
- Health savings account
- Paid holidays
Managed Services - Network Field Services Specialist
PwC —New York, NY
- $44,200 - $91,000 a year
- Full-time
- Computer science
- Computer Science
- Mid-level
- Paid holidays
- Health insurance

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Provider Engagement Network Specialist - Hybrid

EmblemHealth -
New York, NY

Apply Now

Job Details

$56,160 - $99,360 a year

Qualifications

Microsoft Excel
Finance
Client rapport building
Employee relationship building
Health insurance knowledge
Customer engagement
Productivity software

Full Job Description

Summary of Job

Act as a liaison and operate as a vital link between specific Providers and EmblemHealth. Responsible for day-to-day operations for all activities related to contracts with minimal supervision and direction, contract optimization, implementation of new programs and to assist with provider issues, education materials, as well as communication of Plan policies and procedures. Contact for all escalated issues from the Provider and internal EmblemHealth departments, including grievances, disputes, and provider/member billing complaints. Note: the term “Provider” can include managing entity for health systems, facilities such as a specialty office, large faculty and group practices, delegated relationships, ancillary or ambulatory centers, value-based relationships, and the like.

Responsibilities

Assist providers in all matters related to contract disputes and ensure accurate contract and rate load implementations are done in a timely manner.
Communicate with providers and respond to provider inquiries in a timely, accurate, and professional manner with minimal direction from leadership.
Support the timely completion/coordination of claim inquiries and complaints for the Hospital, Ancillary, and/or Professional network.
Provide timely, useful, and accurate responses to provider requests. This includes but is not limited to provider requests for Plan materials, and provider questions regarding fees, the Plan’s website and IVR, information in the Plan’s Provider Manual, and escalated claim inquiries.
Lead and facilitate provider meetings to drive resolution of policy, payment, contractual, or other items; including but not limited to Joint or Administrative Operating Committees.
Assist participating providers or internal partners when issues require coordination of various Plan departments. These departments include but are not limited to Claims, Care Management, EDI, Grievance and Appeal, Customer Service, Enrollment, Special Investigations, Compliance, and Credentialing.
Ensure and coordinate notification and education of various departments within EmblemHealth on contract terms and related issues and conditions.
Support provider network development initiatives, including network builds, provider recruitment, network expansions.
Complete end-to-end contracting process for standard arrangements, including outreach, contract execution, contract loading, and implementation.
May recruit available providers to fulfill Network deficiencies.
Ensure the accuracy of provider demographic data in the Plan’s database. This includes but is not limited to reviewing provider data for assigned Providers, assisting providers with demographic maintenance and updates, researching provider address discrepancies identified by provider returned mail and potential provider demographic errors identified by other Plan departments or initiatives.
Other provider data validation projects as assigned to support strategic network or administrative efficiency initiatives.
Ensure regulatory and provider network compliance requirements are met for assigned providers.
Coordinate delegated oversight functions and activities.
Perform outreach projects which may include requests by the Plan’s State Sponsored Programs Department for DOH, IPRO and DOI notices, HEDIS medical record retrieval and other projects as needed. All outreach documented in compliance with department standards.
Perform additional duties as assigned.

Qualifications

Bachelors’ degree in Healthcare-related field, Public Administration, or Management.
3 – 5+ years of direct provider relations experience (Required)
Knowledge of provider and payor roles, responsibilities and challenges. An understanding of health care financing, access issues, delivery systems, quality controls, and legislation (Required)
Strong customer service skills and the ability to maintain an excellent rapport with providers and their staff (Required)
Ability to work well with various Plan departments is instrumental in the effectiveness of the position (Required)
Excellent communication skills, written and verbal, to ensure that the appropriate requests are articulated and that problems are accurately represented for resolution (Required)
Time management skills and flexibility to work on multiple projects/assignments simultaneously, with ability to change focus in a crisis situation. Willingness to assume diverse duties and challenges (Required)
Interpersonal skills to effectively maintain working relationships to get issues resolved or to obtain information through people, and to represent the Plan and the Department in a favorable light (Required)
Ability to work independently assignments and maximize opportunities to support (Required)
Analytical and problem-solving skills to identify needs in provider relationships, make recommendations as projects develop and follow through to resolution using available resources to achieve a solution (Required)
Proficiency testing in Excel, Word and other Microsoft applications (Required)
PC skills including proficiency in Microsoft Office Suite (Required)

Additional Information

Requisition ID: 1000003097
Hiring Range: $56,160-$99,360

Apply Now

Refine Your Search

network specialist jobs in new york, ny

Provider Engagement Network Specialist - Hybrid

Provider Network Specialist

Network Support Specialist

Executive IT Support Specialist

IT Specialist

IT Support Specialist I

Information Technology - IT Service Specialist

Desktop Support Technician

IT Logistics Specialist

Lead Technician - Corporate Services

School Technology Specialist - NYC

Computer Support Technician II

Clinical Business Analyst I

System Support Specialist - Full Time; 9171-318-N

Cyber Risk Analyst

Tenant Relocation Specialist

SENIOR LAN SPECIALIST

Desktop Support Specialist

Technical Support Specialist

Managed Services - Network Field Services Specialist

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