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Network Sourcing and Development Specialist
Location
United States
Posted
24 days ago
Salary
Not specified
Bachelor Degree3 yrs expEnglish
Job Description
• 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.
Job 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
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