Provider Network Growth & Relations Lead

Workplace Options; Texas; On-site; USD 65,000 - 90,000; Full time

Job summary

Workplace Options supports Behavioral Health Systems (BHS) with a Network Recruitment and Development Specialist role in the US. The position focuses on expanding and maintaining the PPO network, identifying providers, and negotiating rates.

Reporting to the Vice President, Provider Relations, you will orient providers, liaison with treatment teams, and assist in client contract support and provider training. This is a full-time opportunity based in the US.

Qualifications

• Bachelor's degree in related field is required.
• Three years provider relations experience, preferably with PPO/HMO or similar setting.
• Experience in managed care/PPO environment is required.
• Some 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 with fiscal issues, rate negotiations, contractual terms.
• Excellent communication and organization skills.

Responsibilities

• Develop, expand and maintain PPO network; identify, solicit and rate-negotiate with providers; coordinate rate negotiations.
• Assist in conducting provider orientations with regional training sessions.
• Serve as liaison with treatment providers, clients and patients; resolve problems promptly.
• Support Clinical Division; assist with client/case-specific provider hookups and problem-solving.
• Assist in proposals and other services related to client contracts as requested.
• Maintain policies and procedures; suggest revisions to forms and rates as appropriate.
• Participate in marketing and provider relations efforts; coordinate provider rate data by region or city and national statistics; prepare reports.

Skills

Provider relations

Managed care PPO

Mental health exposure

Communication skills

Problem solving

Education

Bachelor's degree in related field

Tools

PC proficiency

Microsoft Word

Microsoft Access

Job description

About this opportunity:

Workplace Options is proud to support our sister organisation, Behavioral Health Systems (BHS), in recruiting a Network Recruitment and Development Specialist. If you’re passionate about building strong provider networks and making a real impact, this is your chance to be part of something meaningful and transformative.

BHS operates one of the nation’s largest specialty preferred provider organizations (PPO), which is comprised of psychiatrists, psychologists, social workers, EAP providers as well as facility networks including hospitals, rehab/residential treatment centers, partial hospitalization programs and intensive outpatient programs. BHS fully credentials and panels their own network of providers.

Current Opportunity:Network Recruitment and Development Specialist

Location: US

Full-time/Part-time:This is a full-time (40 hours per week) position.

What you will do:

Reporting to the Vice President, Provider Relations, this position isresponsible for continued development of PPO network, PPO rate negotiations, and orientation ofproviders.

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. AssistClinical Division as directed in client/case-specific provider hook-ups and problem-solving.
• Assist Clinical Division and Accounting/Marketing Divisions as requested in support servicesrelated to specific or potential client contracts. Assist in preparation of proposals asrequested.
• Maintain corporate, departmental and quality assurance policies and procedures.Recommend new policies/procedures as deemed appropriate. Recommend revisions to PPOcontract forms and rates as appropriate.
• Participate in on-going marketing and provider relations efforts, as directed. Participate inspecial projects, on-going research and public relations efforts as appropriate. Coordinateinformation on competition, provider rates by region or city, national statistics and relevantchanges 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 asrequested. Advise Vice President, Provider Relations on developments in the field.

Qualifications/Skills:

• Bachelors in related field.
• Three years provider relations experience required, preferably with PPO/HMO or similarsetting.
• 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.

For further information about BHS please seehttps://behavioralhealthsystems.com/

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