Network Engineer

• Assure providers are set up accurately in the provider information system for state reporting, claims payment, and directories
• Manage state deliverables, network reporting, directories, and claims payment resolution related to provider setup
• Support external provider representatives in resolving provider data issues
• Research and respond to provider-related issues
• Act as internal and external liaison for provider networking
• Maintain relationships with participating physicians, physician groups, multi-specialty groups, and ancillary providers
• Act as account manager and gatekeeper for assigned groups
• Administer contractual provider relationships and maintain accurate provider databases
• Provide training, education, and information to providers
• Research, analyze, and resolve complex contract, claims, eligibility, appeals, grievance, and provider data issues
• Serve as primary liaison between assigned providers and the health plan
• Act as department subject matter expert
• Perform other duties as assigned and comply with policies and standards

Network Engineer jobs in New Jersey

Senior Provider Engagement Network Specialist