Covenant HealthCare · 15 hours ago
NETWORK DEVELOPMENT SPECIALIST
Saginaw, MI
Full-time
Onsite
Entry, Mid LevelCovenant HealthCare is committed to providing extraordinary care for every generation. The Network Development Specialist plays a crucial role in maintaining accurate provider data and ensuring the integrity of the provider network, while also supporting payer relations and enrollment processes.
Health CareHospitalMedical
Responsibilities
Responsible for oversight of CHP provider rosters, both internal and external
Maintains internal provider database continuously and consistently to ensure that accurate and current information is available to all stakeholders
Audit, assess, implement, effectively utilize, and maintain provider database processes and information systems
Establish working relationships with all stakeholders
Evaluate the adequacy of the provider network to identify gaps in covered specialties and make recommendations to CHP leadership to help grow the provider network
Work with CHP credentialing staff, Covenant HealthCare's Central Billing Office and Medical Staff Office to ensure provider additions, deletions, and changes are shared and reconciled and that any updates are properly reflected in CHP rosters and credentialing software
Ensure discrepancies are addressed promptly and the proper follow-ups are completed in a timely manner
Serve as main point of contact for external queries regarding CHP provider roster and provider data
Organize information and data to identify/explain trends, problems, and their causes
Securely manage and maintain data integrity
Evaluate, analyze, and recommend software upgrades, changes, interfaces, and modules
Work with payer partners and payer platforms provider data integrity, attestations, and annual audits
Responsible for CIN execution of participation agreement for newly approved providers
Responsible for collection of documents for physician payer enrollment in CHP contracts and disenrollment when physician terminates membership
Responsible for select payer patient discharges
Other duties as assigned
Qualification
Required
Associate's degree in health services administration or business required
Experience with electronic credentialing software, MD Staff or other credentialing software
Excellent computer knowledge and capability to use computer programs as required
Achieve the process of change by recognizing and communicating the need
Express thoughts clearly, concisely, and effectively both verbally and in writing
Excellent communication, both written and verbal, and interpersonal skills
Ability to adapt behavior in response to new information or changing circumstances
Ability to work and collaborate effectively with others in unstructured or dynamic environments
Understand information technology concepts, key functions, terminology, and work products
Knowledge of CAQH and NCQA
Understand current performance improvement concepts and ideas, such as setting goals, implementing systemic changes, measuring outcomes, and optimizing resources to meet the needs of the organization
Exhibit confidence and professional diplomacy while identifying, organizing, facilitating and/or sustaining mutually beneficial partnerships with people of all levels internally as well as externally
Present in a confident, clear, and enthusiastic manner when addressing people in a small or large group
Inspire trust and confidence among stakeholders through reliability, authenticity, and accountability
Displays a credible presence and positive image when representing the organization
Excellent organization, time management skills and attention to detail
Commit to continuous performance and process improvement
Encourage and facilitate cooperation, trust, and group identity; and build commitment, team spirit, and strong relationships
Computer and word processing ability including MD Staff, Microsoft Office Suite (Word, Excel, PowerPoint, Teams)
Demonstrates ability to maintain information in a confidential manner
Customer Service focused on all daily activities
Demonstrates ability to make sound independent decisions within boundaries of policies and procedures
Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
Constant sitting
Frequent carrying, handling, tasting, and smelling
Frequent lifting 11-25 lbs
Occasional lifting 26-50 lbs
Occasional standing, walking, talking and hearing, pushing, pulling, stooping, kneeling, and squatting
Constant near vision, far vision, depth perception, color vision and field of vision
Preferred
Bachelor's degree in health services administration or business preferred
Company
Covenant HealthCare
Covenant HealthCare is a group of six private acute medical hospitals.
Founded in 1997
1001-5000 employees
H1B Sponsorship
Covenant HealthCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (20)
2024 (13)
2023 (19)
2022 (24)
2021 (11)
2020 (17)
Funding
Current Stage
Late StageTotal Funding
unknown2002-01-01Acquired
Leadership Team
Beth Charlton
Vice President Patient Services and Chief Nursing Officer
Recent News
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