BlueCross BlueShield of Tennessee · 11 hours ago
Network Manager II
Memphis, TN
Full-time
Onsite
Mid Level
3+ years expBlueCross BlueShield of Tennessee is seeking a Provider Network Manager II who is passionate about supporting providers and driving meaningful impact across their network. In this role, you will collaborate with providers to solve operational and technical challenges, manage escalated enrollment, and lead data-driven reporting to strengthen provider relationships.
Health CareMedical
Responsibilities
Identifying educational topics, methods, and strategies to enhance compliance throughout the provider network
Implementing, supporting, and monitoring provider programs and enterprise initiatives
Implementing processes and changes needed to maintain regulatory compliance, contract compliance or to improve quality
Handling escalated provider enrollment processing and problem resolution
Leading data reporting and analysis projects to monitor financial and service relations with providers
Consulting with providers on delivery, training and support related issues, identifying opportunities for enhancement and recommending solutions
Able to travel to provider offices or conduct virtual meetings as required
Qualification
Required
Strong understanding of LTSS programs and EVV requirements
Proven experience in network development and contract management
Candidates must live in Memphis TN or within 35 miles
This job does require travel in the West TN Region
Bachelors degree in business or healthcare or relevant field or equivalent work experience required
3 years - Experience in provider relations and network development with emphasis on healthcare education and reimbursement
Ability to speak in public and conduct effective presentations
Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability
Demonstrated ability to interpret and translate technical and/or or complex concepts into information meaningful to project team members and/or business personnel
Proficient in Microsoft Office (Outlook, Word, Excel, Access and PowerPoint)
Accuracy and attention to detail
Effective time management skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Strong analytical skills
Ability to manage multiple projects and priorities
Positive attitude, self-driven, engaging, proactive, results drive
Knowledge in Medical terminology
Knowledge of contract language and reimbursement methodologies, managed care business processes, case-mix adjustment, medical terminology, utilization management and applications for claims payment
Valid Driver's License
Company
BlueCross BlueShield of Tennessee
As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years.
5001-10000 employees
H1B Sponsorship
BlueCross BlueShield of Tennessee 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 (26)
2024 (38)
2023 (36)
2022 (44)
2021 (56)
2020 (58)
Funding
Current Stage
Late StageLeadership Team
Casey Dungan
President and Chief Executive Officer - BlueCare
Melissa Scissom
COO, Cover Tenn
Recent News
2026-01-06
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