Intelligent Transportation Systems Project Manager
Leidos
Cyber Security
Network Manager II
BlueCross BlueShield of Tennessee
full-time
Posted on:
Location Type: Hybrid
Location: Knoxville • Tennessee • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Identifying educational topics, methods, and strategies to enhance compliance throughout the provider network.
- Implementing, supporting, and monitoring provider programs and enterprise initiatives
- Implementing processes and changes needed to maintain regulatory compliance, contract compliance or to improve quality.
- Handling escalated provider enrollment processing and problem resolution.
- Leading data reporting and analysis projects to monitor financial and service relations with providers.
- Consulting with providers on delivery, training and support related issues, identifying opportunities for enhancement and recommending solutions.
- Able to travel to provider offices or conduct virtual meetings as required.
Requirements
- 3 years of experience in provider relations and network development with emphasis on healthcare education and reimbursement
- Claim adjudication experience related to facility and professional providers
- Established relationships with providers in the Knoxville market
- Strong interpersonal skills, as building strong partnerships is key to the success in this role
- FACETS knowledge is preferred but not required
Benefits
- Employees who are required to operate either a personal or rental vehicle for company business on a routine basis will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR).
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
provider relationsnetwork developmenthealthcare educationreimbursementclaim adjudicationdata reportingdata analysis
Soft skills
interpersonal skillsproblem resolutionconsultingpartnership building
