Medicare Network Manager

A company is looking for a Manager, Provider Network - Medicare.

Key Responsibilities

Oversee recruitment, contracting, and onboarding of providers to ensure network adequacy for Medicare Advantage markets

Build and maintain strong relationships with providers and health systems while managing day-to-day provider relations functions

Ensure compliance with CMS, state, and NCQA standards in all contracting and credentialing activities

Required Qualifications

Bachelor's degree in Healthcare Administration, Business, or related field required; Master's degree preferred

Minimum 5-7 years in provider network management or contracting within a Medicare Advantage or managed care environment

Understanding of CMS requirements, risk-based contracting, and provider reimbursement methodologies

Experience leading teams and managing cross-functional projects

Proficient in Microsoft Office and provider network management tools