Senior Specialist, Provider Network Administration (SQL)

54306 Green Bay, Wisconsin Molina Healthcare

Posted 7 days ago

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Job Description

**JOB DESCRIPTION**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases (using SQL, Excel, and QNXT). Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Generates and prepares provider-related data and reports (using SQL, Excel and QNXT) in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
+ Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
+ Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
+ 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 5+ years managed care experience
+ QNXT; SQL experience
+ Crystal Reports for data extraction
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $45,390 - $88,511.46 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Specialist, Provider Network Administration (EST business hours)

54306 Green Bay, Wisconsin Molina Healthcare

Posted 16 days ago

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Job Description

**JOB DESCRIPTION**
**This role will have standard EST business hours.**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
+ Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
+ Audits loaded provider records for quality and financial accuracy and provides documented feedback.
+ Assists in configuration issues with Corporate team members.
+ Assists in training current staff and new hires as necessary.
+ Conducts or participates in special projects as requested.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree in Business or equivalent combination of education and experience
**Required Experience**
+ Min. 3 years managed care experience
+ Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
+ Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 3+ years Provider Claims and/or Provider Network Administration experience
+ Experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Travel Nurse RN - Administration/Management - $2,178 per week

54311 Bellevue, Wisconsin Travel Nurse Source

Posted 2 days ago

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Job Description

TravelNurseSource is working with OneStaff Medical to find a qualified Admin/Mgmt RN in Menomonee Falls, Wisconsin, 53051!

Pay Information
$2,178 per week

About The Position

We. Are. OneStaff. Medical. An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country. We want the same like-minded, awesome candidates to travel with us. Be bold. Enjoy work again. Let us help.

THE POSITION: Directors of nursing are registered nurses who wish to assume more responsibility in a managerial capacity. They supervise and review nursing staff, oversee the department budgets, and report to high-level staff members. They also, maintain high standards of care, manage patient data and medical records, and interact with docters, patients and family members. Id -

*Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details.

**Equal Opportunity Employer**

Requirements:

Minimum of 1 year of current work experience providing in . State Healthcare Provider license or willing to obtain one.

Certifications Needed:

This position may require one or more of these certifications:

BENEFITS:

Insurance

We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection.
401K   You are eligible to enroll 1st of the month following hire date. We match 100% of your first 3% of deferrals and an additional 50% of the next 2% you contribute. 
Employee Assistance Program Free to all employees who'd like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.

EXPPLAT

About OneStaff Medical

Consistently recognized by Inc. 5000 as one of the fastest growing privately-held companies in the U.S., OneStaff Medical walks that line between the “flexible start up” mentality and still offering the great office environment perks of some larger corporate 'best places to work.' Our humble travel nurse and allied healthcare recruiting agency, was founded in 2010 by a couple fellas wanting to have a more personal touch on the clients they work for, and the employees they hire to work with. Very true that the industry (and healthcare in general) is constantly changing, but we don't believe that how we partner with our healthcare professionals, or interact with our internal staff, should. Regardless of how big we may get, our main focus is to remember who makes this all work. That's our employees, whether nurses or internal. Our core principles about customer service, dedication, hard work, and still always making it fun while doing it all, will never change. At the end of the day, we are a (customer) service company, we just make it fun because of the exceptional talent and sparkling souls we seek out and hire. We know we all grow this, and grow us, together.

We are OneStaff Medical. Let's dance!

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Travel Nurse RN - Administration and Management - $2,451 per week

54311 Bellevue, Wisconsin Travel Nurse Source

Posted today

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Job Description

TravelNurseSource is working with FlexCare to find a qualified Admin/Mgmt RN in Madison, Wisconsin, 53701!

Pay Information
$2,451 per week

About The Position

FlexCare is a nationwide leader in the staffing of travel nurses and clinicians. With access to thousands of facilities around the country, our mission is to deliver premier travel staffing solutions with integrity and transparency. FlexCare's exceptional service and reputation make it one of the most awarded healthcare staffing companies in the industry each year, ranking as one of the top travel nursing companies in the nation from industry authorities like Highway Hypodermics, Travel Nursing Central, and BluePipes. FlexCare has also been recognized by hospital MSP's with awards such as; Partner of the Year, Largest Patient Impact, and Most Engaged Travel Associate.

EXPPLAT

Job Requirements
  • Valid RN License


Benefits

FlexCare's robust benefits package for all travel assignments includes:

  • MaxPay - our commitment to offer the maximum pay package without making you negotiate, for every position, every time, right from the start
  • S1NGLEPOINT - a single point of contact who personally takes care of all your assignment details, questions, and everything in between
  • Virtual Recruiter - 24-hour job monitoring based upon your preferences and delivered to your inbox every day when you wake up
  • Medical, Dental, and Vision Insurance
  • 401k with Employer matching

Fair Chance Policy

In accordance with the Los Angeles County Fair Chance Ordinance, FlexCare conducts a review of criminal history after a conditional offer of employment has been made and qualified applicants with arrest or conviction records will be considered for employment. Please note that certain criminal histories may have a direct, adverse, and negative relationship with the duties of a nursing position, potentially leading to the withdrawal of a conditional offer of employment. These duties include, but are not limited to, providing direct patient care, administering medication, handling sensitive patient information, maintaining patient safety, and upholding ethical standards in compliance with healthcare regulations. Additionally, the review may consider the potential impact on the nurse's ability to meet licensing and regulatory requirements as mandated by relevant healthcare agencies, including the California Board of Registered Nursing and other governing bodies. The nature and gravity of any criminal offense, the time that has passed since the offense or completion of the sentence, and the nature of the job sought will be considered during the review process.

About FlexCare

FlexCare is an award-winning nationwide leader in travel nursing, allied health, and therapy talent management solutions for top healthcare facilities throughout the U.S.

Since 2006, FlexCare has been committed to helping address critical personnel needs in healthcare, ensuring facilities have access to the best clinical talent to meet patient needs while unlocking career opportunities for travel clinicians and supporting them to provide the highest level of patient care possible.

For clinicians, we open doors to rewarding travel assignments with top facilities nationwide, backed by dedicated support every step of the way. For healthcare facilities, we provide access to exceptional talent when and where they need it most.

We are more than a staffing agency – we're a trusted healthcare partner who builds meaningful relationships to improve lives, advance careers, and set the standard for excellence in healthcare talent management.

What Makes FlexCare Different:

·    Single Point of Contact for All You Need: Our clinicians always have a dedicated recruiter who handles everything, saving them time, reducing their stress, and building lasting relationships. 

·    Fast-Track to Travel Platform: Our platform offers our clinicians an all-in-one hub for finding assignments, managing credentials, and streamlining their travel careers. 

·    Pay Package Peace of Mind : We present our clinicians with the best offer, up front. Eliminating the back-and-forth and uncertainty, and ultimately placing them into an assignment, faster.

·    Award-Winning Team That Goes Above & Beyond: Our clinicians have an entire team of healthcare experts, ranked top in the industry, to support their success, from payroll to clinical support to compliance.  

FlexCare pushes beyond healthcare staffing through our high-touch, high-results approach. We’re leaders in healthcare talent management who focus on what matters most - matching the right clinicians with the right facilities to deliver quality patient care

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Returning Business Administration Intern- Summer 2026- Great Lakes Division- For Current/Former H...

54304 Green Bay, Wisconsin HNTB

Posted 16 days ago

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Job Description

**What We're Looking For**
This position is for current/former HNTB Interns only.
At HNTB, you can create a career that is meaningful to you while building communities that matter to all of us. For more than a century, we have been delivering solutions for some of the largest, most complex infrastructure projects across the country. With our historic growth, it is an exciting time to join our team of employee-owners.
This opportunity entails, while under close supervision, assist assigned department(s) and/or project(s) by performing basic and routine administrative support work and other related tasks which may reflect elements of standard post-secondary business curriculum, usually on a part-time, temporary, or co-op basis.
Relocation and housing are not provided for this position.
**What You'll Do:**
+ Performs a variety of tasks which may be specific to a particular functional area of activity such as preparing reports, tracking and evaluating results, coordinating program developments, answering the phone, receiving messages, transmitting information, making copies, editing documents, handling routine inquires and making appointments.
+ Participates in meetings and interfaces with various teams.
+ Assists management in analyzing various data.
+ Works on special projects and provides research as needed.
+ Performs other duties as assigned.
**What You'll Need:**
+ High School Diploma/GED or equivalent plus enrolled in a related undergraduate or graduate program
**What We Prefer:**
+ Working knowledge of MS Word, Excel, and PowerPoint
+ Ability to work independently
+ Ability to prioritize work and multi-task
**Additional Information**
Click here for benefits information: HNTB Total Rewards
Click here to learn more about Equal Opportunity Employer/Disability/Veteran
Visa sponsorship is not available for this position.
#MZ
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Locations:
Allen Park, MI, Ashwaubenon, WI (Green Bay), Blue Ash, OH (Cincinnati), Chicago, IL, Cleveland, OH, Columbus, OH, Detroit, MI, Downers Grove, IL, East Lansing, MI (Lansing), Grand Rapids, MI, Indianapolis, IN, Jackson, MI, Madison, WI, Milwaukee, WI (East Wisconsin Avenue), Minneapolis, MN, Sterling Heights, MI, Westfield, IN (Carmel)
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The approximate pay range for Ohio is $18.65 - $7.98. Please note that the pay range provided is a good faith estimate for the position at the time of posting. Actual compensation will be dependent on factors, including but not limited to, the individual's qualifications, experience, knowledge, skills, and abilities as well as physical work location within the state.
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The approximate pay range for Minnesota is 19.58 - 29.38. Please note that the pay range provided is a good faith estimate for the position at the time of posting. Actual compensation will be dependent on factors, including but not limited to, the individual's qualifications, experience, knowledge, skills, and abilities as well as physical work location within the state.
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The approximate pay range for Illinois is 20.52 - 30.77. Please note that the pay range provided is a good faith estimate for the position at the time of posting. Actual compensation will be dependent on factors, including but not limited to, the individual's qualifications, experience, knowledge, skills, and abilities as well as physical work location within the state.
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_NOTICE TO THIRD-PARTY AGENCIES:_
_HNTB does not accept unsolicited resumes from recruiters or agencies. Any staffing/employment agency, person or entity that submits an unsolicited resume to this site does so with the understanding that the applicant's resume will become the property of HNTB. HNTB will have the right to hire that applicant at its discretion and without any fee owed to the submitting staffing/employment agency, person or entity. Staffing/employment agencies who have fee agreements with HNTB must submit applicants to the designated HNTB recruiter to be eligible for placement fees._
**Job Type:** Intern
**Full/Part Time:** Full time
**Job Category:** Administration Group
**ReqID:** R-26780 #college
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