Provider Network Compliance Consultant

Job Summary

A company is looking for a Provider Network Compliance Consultant.

Key Responsibilities

• Monitor compliance of provider networks with state, federal, and NCQA requirements
• Maintain relationships with state regulatory analysts and resolve compliance issues
• Analyze data for NCQA reports and present findings to executive management

Required Qualifications, Training, and Education

• Bachelor's degree or four years of relevant work experience
• Six years of experience in healthcare, including four years in regulatory compliance
• Experience working with state and/or federal regulators (preferred)
• Experience in analyzing provider network adequacy (preferred)
• Experience in developing or managing healthcare products (preferred)