4 Administration jobs in Idaho Falls
Senior Specialist, Provider Network Administration
83404 Iona, Idaho
Molina Healthcare
Posted today
Job Viewed
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. 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 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: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**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**
+ Generates and prepares provider-related data and reports 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: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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0
Specialist, Provider Network Administration - Remote
83404 Iona, Idaho
Molina Healthcare
Posted today
Job Viewed
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. 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)
+ Credentialing Knowledge
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.
**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)
+ Credentialing Knowledge
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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1
Director, Medicare Administration (Regulatory SME) - REMOTE
83404 Iona, Idaho
Molina Healthcare
Posted today
Job Viewed
Job Description
**JOB DESCRIPTION**
**Job Summary**
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Establishes audit controls and measurements to ensure correct processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit findings and recommendations to ensure contractual State and Federal Compliance.
+ Coordinates development of written policies and procedures regarding compliance with local, state and federal guidelines.
+ Establishes member grievance appeals and policies and updates annually or as directed by the Centers for Medicare and Medicaid Services.
+ Establishes non-contracted provider dispute and appeals policies and policies and updates annually or as directed by the Center for Medicare and Medicaid.
+ Responsible for development, implementation, and maintenance of department strategic initiatives.
**JOB QUALIFICATIONS**
**Required Education**
Graduate Degree or equivalent combination of education and experience
**Required Experience**
7-9 years
**Preferred Experience**
10+ years
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: $88,453 - $172,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Summary**
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Establishes audit controls and measurements to ensure correct processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit findings and recommendations to ensure contractual State and Federal Compliance.
+ Coordinates development of written policies and procedures regarding compliance with local, state and federal guidelines.
+ Establishes member grievance appeals and policies and updates annually or as directed by the Centers for Medicare and Medicaid Services.
+ Establishes non-contracted provider dispute and appeals policies and policies and updates annually or as directed by the Center for Medicare and Medicaid.
+ Responsible for development, implementation, and maintenance of department strategic initiatives.
**JOB QUALIFICATIONS**
**Required Education**
Graduate Degree or equivalent combination of education and experience
**Required Experience**
7-9 years
**Preferred Experience**
10+ years
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: $88,453 - $172,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
2
Dental Office Manager
83404 Iona, Idaho
Aspen Dental
Posted today
Job Viewed
Job Description
At Aspen Dental, we put You First, offering the security and job stability that comes with working with a world-class dental service organization (DSO). Our best-in-class training program, competitive compensation, and flexible scheduling will help you thrive in your career. When you join our team as a **Dental Office** **Manager** , which at Aspen Dental we call an Operations Manager, you will have the opportunity to give back to communities and positively affect patients' lives.
**Job Type:** Full-Time
**Salary:** $5000 - $55000 / year + monthly and quarterly incentive earnings **
**At Aspen Dental, we put You First. We offer:**
+ A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match*
+ Career development and growth opportunities to support you at every stage of your career
+ A fun and supportive culture that encourages collaboration and innovation
+ Free Continuous Learning through TAG U
**How You'll Make a Difference:**
As a **Dental Office Manager** , you will lead the office in all office operations in support of the doctors to help create lasting impressions and build trust and loyalty with patients. When you join an Aspen Dental practice, you'll participate in an extensive, ten-week training program to gain business and leadership knowledge designed to help you succeed and grow within our organization.
+ Provide superior patient service with compassion and care in accordance with patient needs, company policies and procedures, government regulations, and dental board standards
+ Hire, develop, manage and retain the office staff
+ Consult with patients on treatment options provided by clinical team, verifying insurance payment and collection ensuring high quality of care
+ Review monthly business results, manage profit and loss, align sales plan to support business goals and create strategies to increase profitability
+ Prepare and lead daily huddles with team to level set expectations to optimize patient experience and business performance
+ Additional tasks as required
**Preferred Qualifications**
+ Minimum of one year of managing a team of direct reports
+ High school diploma or equivalent; college degree is preferred
+ A people centric leader who motivates and inspires others
+ Strong communication and interpersonal skills, with the ability to build rapport with patients of all ages and backgrounds
+ Demonstrate analytical thinking; place a premium on leveraging data
_Aspen Dental-branded practices are independently owned and operated by licensed dentists. The practices receive non-clinical business support services from Aspen Dental Management, Inc., a dental support organization._
_*May vary by independently owned and operated Aspen Dental locations._
_**Limitations apply, please see recruiter for details_
_ADMI Corp., d/b/a TAG-The Aspen Group, its affiliates, related companies and independently owned supported clinical practices are proud to be Equal Opportunity Employers and welcome everyone to apply. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, or protected veteran status and will not be discriminated against on the basis of disability._
**Job Type:** Full-Time
**Salary:** $5000 - $55000 / year + monthly and quarterly incentive earnings **
**At Aspen Dental, we put You First. We offer:**
+ A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match*
+ Career development and growth opportunities to support you at every stage of your career
+ A fun and supportive culture that encourages collaboration and innovation
+ Free Continuous Learning through TAG U
**How You'll Make a Difference:**
As a **Dental Office Manager** , you will lead the office in all office operations in support of the doctors to help create lasting impressions and build trust and loyalty with patients. When you join an Aspen Dental practice, you'll participate in an extensive, ten-week training program to gain business and leadership knowledge designed to help you succeed and grow within our organization.
+ Provide superior patient service with compassion and care in accordance with patient needs, company policies and procedures, government regulations, and dental board standards
+ Hire, develop, manage and retain the office staff
+ Consult with patients on treatment options provided by clinical team, verifying insurance payment and collection ensuring high quality of care
+ Review monthly business results, manage profit and loss, align sales plan to support business goals and create strategies to increase profitability
+ Prepare and lead daily huddles with team to level set expectations to optimize patient experience and business performance
+ Additional tasks as required
**Preferred Qualifications**
+ Minimum of one year of managing a team of direct reports
+ High school diploma or equivalent; college degree is preferred
+ A people centric leader who motivates and inspires others
+ Strong communication and interpersonal skills, with the ability to build rapport with patients of all ages and backgrounds
+ Demonstrate analytical thinking; place a premium on leveraging data
_Aspen Dental-branded practices are independently owned and operated by licensed dentists. The practices receive non-clinical business support services from Aspen Dental Management, Inc., a dental support organization._
_*May vary by independently owned and operated Aspen Dental locations._
_**Limitations apply, please see recruiter for details_
_ADMI Corp., d/b/a TAG-The Aspen Group, its affiliates, related companies and independently owned supported clinical practices are proud to be Equal Opportunity Employers and welcome everyone to apply. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, or protected veteran status and will not be discriminated against on the basis of disability._
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