Provider Network Growth & Negotiations Specialist

workplaceoptions; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Workplace Options is seeking a Network Recruitment and Development Specialist to expand and manage the PPO provider network, negotiate rates, and orient new providers. Reporting to the VP of Provider Relations, the role supports growing the network and improving access to behavioral health services.

The position requires three years of provider relations experience, strong communication and negotiation skills, and the ability to work cross-functionally with clinical and accounting teams.

Qualifications

• Bachelor's degree in a 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.

Responsibilities

• 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.

Skills

Provider relations

PPO knowledge

Rate negotiations

Public relations

Communication skills

Organization skills

Presentation skills

Problem solving

Phone outreach

Education

Bachelor's in related field

Tools

PCs

Word

Access

Internet

Job description

Workplace Options is seeking a Network Recruitment and Development Specialist to expand and manage the PPO provider network, negotiate rates, and orient new providers. Reporting to the VP of Provider Relations, the role supports growing the network and improving access to behavioral health services.

The position requires three years of provider relations experience, strong communication and negotiation skills, and the ability to work cross-functionally with clinical and accounting teams.