TruHealth
Location (5)
Mobile, Alabama
Locations
The role involves contracting providers and essential vendors to maintain CMS adequacy and ensuring they meet credentialing requirements for member care. Responsibilities also include educating providers on Health Plan functions and monitoring relationships to maintain network coverage.
Candidates must possess fluency in current provider payment methodologies like per diems, DRGs, and APCs, along with knowledge of medical services and strong organizational and presentation skills. A Bachelor's degree is required, and prior experience in healthcare, network development, or with Medicare Advantage plans is preferred.
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations.
If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!
• Bachelor’s degree
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
This employer participates in E-Verify.
