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Organizes, directs and controls the operations of an integrated physician/hospital network that provides contracting opportunities for managed care payers.: Organizes, directs and controls the entire provider network function including network development, contracting, credentialing, provider relations, and provider services. Establishes physician and hospital recruitment priorities, determines compensation methodologies and negotiates contracts. Ensures a comprehensive, cost-effective, and accessible provider network. Negotiates, administers, extends, terminates, and renegotiates contracts. Formulates and coordinates proposals. Coordinates activities of workers engaged in formulating bid proposals. Evaluates or monitors health outcome and contract performance to determine necessity for amendments or extensions of contracts, and compliance to contractual obligations. Approves or rejects requests for deviations from contract specifications. Arbitrates claims or complaints occurring in performance of contracts. May serve as liaison officer to ensure fulfillment of obligations by contractors. Develops and maintains a network of relationships with leaders involved in the integrated network of physicians.

Top Provider Network Contracting Executive

Provides executive leadership and coordination over Provider Network Contracting operations to include development and implementation of strategic plans that provide sound provider interaction and contracting.: Responsible for the research, policy development, contract development and expansion of the provider network. Plans, organizes and directs the Provider Network Contracting department. Organizes, controls, and evaluates the implementation of strategic plans that provide strong provider relations and contracting. Formulates and administers departmental policies. Plans, organizes, implements and evaluates outcomes of the department’s strategic plans. Develops strategic initiatives and transforms initiatives into action plans. Develops and fosters effective collaboration between departments and other affiliated services to ensure an integrated approach to provider network contracting. Develops new strategies to enhance service and improve overall performance. Develops and maintains administrative and regulatory compliance systems. Reviews budgetary recommendations, and manages and monitors the departmental budget. Hires, develops and motivates a qualified staff. An advanced degree is typically required for this position with seven years of provider relations and contracting experience in managed care.

Network Consultant

Leads network related consultancy, solution, design, and implementation activities. Develops and implements complex single or multi-product network/systems projects. Develops solutions or customizes existing network/systems to meet customer needs.: Presents and communicates technical ideas and solutions. Develops project plans and estimates for time frames, quality, and resources required for successful implementation. Establishes criteria for deliverability, performance, maintenance, design, and cost and makes adjustments as needed throughout the project. Prepares regular status reports. Develops training materials and conducts training for internal and/or external customers. Documents technical builds, configurations, and scopes of work for customer projects. Troubleshoots issues relating to network, server, messaging, etc. Demonstrates knowledge of networking technologies including LAN's, VLAN's, and WLAN's and various modern network topologies including Internet, intranets, and extranets.

Fast Food Manager (Network)

Directs operations over franchised or independent fast food or wholesale-prepared food establishment; directs and coordinates activities of subordinate District Managers involved in operating fast food services. Analyzes market trends and economic conditions to forecast sales potential in areas. Evaluates adequacy of return on investments on individual restaurants and alters or initiates procedures to improve service, sales, and reduce expenses. Examines financial performance of individual restaurants, and reviews and acts on reports that include recommendations for maintenance and repair, changes in operational procedure, marketing, advertising, and purchasing.: Maintains employment records for each District Manager. Terminates employment of District Managers whose performance does not meet company standards. Directs activities of business records, collecting and paying accounts, and ordering or purchasing supplies.

Provider Network Analyst

Analyzes costs and member accessibility of current and prospective provider networks. Performs a general review of physician costs and practice patterns and analyzes costs and member accessibility of current and prospective provider networks. Typically requires a college degree and two years of experience in data collection and analysis. The position may require contract negotiation experience. : Coordinates and disseminates contract information for the organization. Identifies available networks in each market area and requests detailed provider information from each network vendor for analysis. Matches providers against actual claims experience and produces analyses and reports comparing costs and member accessibility of current network versus prospective network. Performs statistical testing of network vendor discounts. Analyzes general physician costs and utilization patterns by market area. Compares treatment patterns against peer group to identify providers with abnormal variances in cost-effectiveness. May negotiate managed care payer contracts and provider contracts.

Network Planning Manager

Manages the long-term strategic planning, development, and installation of digital network systems, such as frame relay, ISDN, and Internet services, to ensure network capacity for current and future organizational requirements. Manages the activities of a group of network planning supervisors, or similar personnel, to monitor all activities of the network facilities. Typically requires eight to ten years of increasingly responsible experience in network planning. This position typically reports to director level.: Designs, develops, maintains, and communicates project plans and schedules for network installations with prioritized requirements. Develops and implements standards and processes for system analysis and support. Manages the evaluation of software and hardware systems to ensure compatibility across the network. Coordinates the acquisition, analysis, and installation of hardware and software at remote locations. Develops and implements policies in support of network and data systems for the organization. Manages and coordinates training of staff responsible for planning and installation of network software and hardware.

Network Control Supervisor

Supervises and coordinates activities of employees engaged in maintaining, analyzing, monitoring, evaluating, implementing, or installing LAN or WAN network systems and resolving user data communication problems to ensure availability to network user. Distributes work assignments and monitors workers' daily logs. Usually requires a four-year college degree in field of specialty; however, some organizations may accept equivalent education and experience combined.: Explains data communications diagnostic and monitoring procedures to operators following vendor's equipment and software instructions. Explains and demonstrates installation of data communication lines and equipment to operators, using hand tools and following vendor manuals. Enters diagnostic commands into computer and determines nature of problem to assist operators to resolve data communication problems. Enters record of actions taken to resolve problem in daily log. Analyzes trends and assists in design and development of network plans. Tests, identifies, and resolves complex problems. Attends staff meetings to report on and resolve recurrent data communications problems. Interfaces with vendors to learn about new data communications technology and system upgrades.

Computer Network Analyst

Analyzes and controls the technical architecture of Local Area Networks and Wide Area Networks. Researches, tests, evaluates, and recommends telecommunications and data network systems. Analyzes workload, including traffic and utilization trends. Interfaces with users, consultants, technical teams, and vendors for maximum guidance in determining the most appropriate type of hardware installation. Supports complex PCs and LAN/WAN networks throughout the organization. Requires advanced knowledge and experience in the area of local and wide area networking, communications, and related hardware and software. Typically requires a bachelor's degree in computer science, MIS, or equivalent, and certification in networks.: Identifies areas of operation that need upgraded equipment, such as modems, fiber optic cables, and telephone wires. Conducts survey to determine user needs. Reads technical manuals and brochures to determine equipment that meets establishment requirements. Visits vendors to learn about available products or services. Tests and evaluates hardware and software to determine efficiency, reliability, and compatibility with existing system, using equipment such as computer terminal and modem. Analyzes test data and recommends hardware or software for purchase. Develops and writes procedures for installation, use, and solving problems of communications hardware and software. Monitors system performance. Instructs users in use of equipment, and assists users to identify and solve data communication problems. May design and develop complex software interface programs. May write technical specifications to send to vendors for bid. May oversee or assist in installation of communications hardware. May perform minor equipment repairs.

Analyst Computer Network

Network Development Manager

Monitors business processes related to network development to determine their efficiency and protective value and to assure integrity of records, information, and systems are in compliance with the organization's policies and standards and government regulations. Develops tactical plans to align network strategies and technologies with future needs. Integrates new networking strategies and technologies effectively.: Oversees marketing efforts in each market. Prepares and analyzes reports and records on functional area and on organizational activities and recommends improvements for upper management. Monitors and reports on achievement of committed action plans to appropriate upper management. Monitors operational and financial performance of agreements using results to guide future negotiations. Meets individually with providers to develop long-term relationships and resolve operational issues. Reviews redline contract language and provides accept/decline recommendations to management. Prepares and analyzes information to evaluate the need for additional providers. Assists in maintenance of ongoing State, governmental, and community relationships.

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