Provider Network Compliance Specialist
Company: VirtualVocations
Location: Lafayette
Posted on: November 8, 2024
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Job Description:
A company is looking for a Provider Network Compliance
Specialist to ensure compliance with regulatory requirements for
provider networks.
Key Responsibilities
Manage compliance activities related to Medicare Advantage and
Qualified Health Plan regulations
Develop, review, and update department policies and procedures,
providing training to staff
Monitor network availability standards and assist in the provider
termination process
Required Qualifications
Bachelor's Degree in Business or Health Care Administration or
related field
3 years of progressive experience in provider network relations,
health plan accreditation, or compliance
Experience in health plan government programs (Medicare, Medicaid)
is a plus
Strong knowledge of CMS regulatory requirements and NCQA
standards
Intermediate Microsoft Office skills (Word, Excel, and
PowerPoint)
Keywords: VirtualVocations, Lake Charles , Provider Network Compliance Specialist, Other , Lafayette, Louisiana
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