18 May Healthcare Network Development Specialist
IN-OFFICE | FULL-TIME
Boulo Solutions is recruiting for Healthcare Network Development Specialist for our client, a Birmingham, AL -based company that is a leader in the mental health field. If you are looking for a great work environment and good culture, this could be a good fit for you!
Employment type: Full-time
Flexibility: In-Office, Culture
Pay: $55,000 -62k.
Benefits: Full benefit package
Summary: Under the general direction of the Vice President, Provider Relations, this position is responsible for continued development of PPO network, PPO rate negotiations, and orientation of providers.
Specific Duties:
Under the direction of the Vice President, Provider Relations, and in cooperation with the Director, Provider Relations and all divisions as deemed appropriate:
1. 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 Director, Provider Relations and Executive Vice President and Chief Financial Officer.
2. Assist in conducting provider orientations, to include individual and regional provider training sessions, as requested.
3. Serve as liaison with treatment providers, clients, patients, and others, as requested. Resolve problems on a timely basis.
4. 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.
5.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.
6.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.
7.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.
8.Perform other related duties as directed or deemed appropriate. Attend meetings as requested. Advise Vice President, Provider Relations on developments in the field.
Qualifications:
– 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.
– Alabama driver’s license and dependable transportation. Ability to travel.
**Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single
qualification. Our clients are dedicated to building a diverse and inclusive workplace. If this role sounds exciting but your past experience doesn't include every qualification, apply anyways! You may be just the right candidate.
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