Network Sourcing and Development Specialist
Workplace Options
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- Develop, expand and maintain PPO network, to include new provider identification, solicitation and rate negotiation.
- Adhere to established provider fee schedules.
- Coordinate rate negotiations with Vice President, Provider Relations and Vice President, Finance.
- Assist in conducting BHS provider orientations, to include individual and regional provider training sessions, as requested.
- Serve as liaison with treatment providers, clients, patients, and others, as requested.
- Resolve problems on a timely basis.
- Provider Relations Division serves in direct support role to the Clinical Division.
- Assist Clinical Division as directed in client/case-specific provider hook-ups and problem-solving.
- Assist Clinical Division and Accounting/Marketing Divisions as requested in support services related to specific or potential client contracts.
- Assist in preparation of proposals as requested.
- Maintain corporate, departmental and quality assurance policies and procedures.
- Recommend new policies/procedures as deemed appropriate.
- Recommend revisions to PPO contract forms and rates as appropriate.
- Participate in on-going marketing and provider relations efforts, as directed.
- Participate in special projects, on-going research and public relations efforts as appropriate.
- Coordinate information on competition, provider rates by region or city, national statistics and relevant changes in the field with Vice President, Provider Relations.
- Make recommendations on product line enhancements.
- Prepare reports as requested.
- Perform other related duties as directed or deemed appropriate.
- Attend meetings as requested.
- Advise Vice President, Provider Relations on developments in the field.
Requirements
- Bachelors in related field.
- Three years provider relations experience required, preferably with PPO/HMO or similar setting.
- Experience in managed care/PPO environment.
- Some experience/involvement in mental health field and public relations preferred.
- Familiarity with case management/util. review functions.
- Familiarity with computerized applications (PCs, Word, Access and the internet).
- Experience in services to business, industry preferable.
- Experience with fiscal issues, rate negotiations, contractual terms.
- Excellent communication skills (written and oral) and organization skills.
- Experience in group presentations/speaking preferable.
- Excellent problem-solving abilities.
- Willing to perform extensive telephone work.
- Professional appearance.
- Cooperative attitude and self-starter.
- Assertive.
- Goal-oriented.
Benefits
- Health insurance
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
provider relationsrate negotiationcontractual termscase managementutilization reviewfiscal issuesproposal preparationquality assurancemarketing strategiesproblem-solving
Soft Skills
communication skillsorganizational skillspresentation skillscooperative attitudeself-starterassertivenessgoal-orientedproblem-solving abilities
Certifications
Bachelor's degree