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Provider Network Compliance Specialist

Company: VirtualVocations
Location: Lafayette
Posted on: November 8, 2024

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, Baton Rouge , Provider Network Compliance Specialist, Other , Lafayette, Louisiana

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