Provider Manager - Nurse

We are seeking an experienced professional for this opening. About the Role - We are seeking a dedicated and experienced Nurseto join our dynamic team. - The ideal candidate will have a strong background in provider network management and will collaborate closely with our Claims Department and Call Center teams to ensure seamless healthcare service delivery and provider coordination. Key Responsibilities: - Manage and maintain relationships with healthcare providers in the network. - Monitor provider performance and ensure compliance with healthcare standards and regulatory requirements. - Work closely with the Claims Department to review and validate medical claims. - Support the Call Center team in resolving provider-related inquiries and complaints. - Ensure adherence to healthcare regulations and internal policy guidelines. - Participate in the onboarding and credentialing of new providers. Requirements: - Interested candidates should possess a Bachelor's Degree with 2-5 years experience. - Strong knowledge of healthcare regulations, policies, and clinical best practices. - Excellent communication and interpersonal skills. - Strong analytical and problem-solving abilities. - Ability to work collaboratively across departments.