Network Management Specialist

Blue Cross and Blue Shield of Vermont is looking for a Network Management Specialist to join our Network Management team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision,401K, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

COMPENSATION: The base hourly range for this position is $23.00-26.00/hour. Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the range listed above is our good faith estimate of the hiring range for this role. If you are hired at Blue Cross and Blue Shield of Vermont, your final base salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the current team. We also offer a robust benefits package with significant value (see below).

Location: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. Fully remote candidates within Vermont (further than 50 miles from our Berlin, VT office), will be considered on a case-by-case basis.

Network Management Specialist Responsibilities:

• Responsible for maintaining and updating complex provider, pricing, and capitation data.
• Analyze audits and reports on all aspects of provider and reimbursement systems, including provider pricing and capitation data
• Participate in the configuration of the provider and reimbursement aspects of the production system.
• Design, create, and develop reports, documentation, and research projects as requested in a variety of areas including pricing, capitation, and contractual arrangements.

Network Management Specialist Qualifications:

• HS Diploma with 1 -2 years of additional education, including courses in business or statistics or related field required;
• BA/BS degree desired.
• 3 - 5 years of insurance industry experience, including 1 - 3 years of experience in Network Management required.

Network Management Specialist Benefits:

• Health insurance (including vision)
• Dental coverage (free to employees)
• Wellness Program
• 401(k) with employer match + automatic employer contribution
• Life Insurance
• Disability Insurance
• Combined time off (CTO) - 20 days per year + 10 paid holidays
• Tuition Reimbursement
• Student Loan Repayment
• Dependent Caregiver Benefits

Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from all backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experience, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment at http://www.bluecrossvt.org/about/diversity-equity-and-inclusion.

• Full job description attached to ADP job posting.