Strategic Provider Partnerships Specialist

VNS Health; New York (NY); Vor Ort; USD 66.000 - 72.000; Vollzeit

Benefits dieser Stelle

Referral bonus opportunities

PTO 30 days + 9 holidays

Health insurance plan for you and your

Employer-matched retirement

Tuition reimbursement for qualifying

Professional growth opportunities

Internal mobility and CEU credits

Zusammenfassung

VNS Health in New York seeks a provider relations professional to manage a lower-complexity portfolio, serve as the primary contact for service, recruitment, contracting and issue resolution, and escalate higher-risk matters.

You will lead onboarding, coordinate implementations, support value-based payment initiatives, and maintain records while expanding capabilities with supervision. The role offers opportunities for growth within a large, mission-driven health system in the New York area.

Qualifikationen

• Bachelor's Degree in healthcare administration, business, public health, health services, communications, education, psychology or relevant work experience required
• Ability to evaluate information, communicate clearly, organize work and follow through on commitments required

Aufgaben

• Manages assigned provider relationships and day-to-day service needs, prioritizing requests and maintaining ownership of issues and commitments through resolution.
• Recruits providers and lead straightforward contract negotiations, repapering and other assigned contracting activities using approved rates and standard terms.
• Investigates and resolves provider issues involving claims and billing, credentialing, provider data, authorizations, utilization management, quality, compliance, member service and contract implementation.
• Leads standard provider onboarding, orientation, education, system access and contract implementation; coordinate responsibilities, information and deadlines across providers and internal departments.
• Prepares for and lead provider operating discussions; communicate policies, performance expectations, corrective actions and available tools, and review account, claims, roster, attribution and service data to identify issues and improvement opportunities.
• Supports value-based payment arrangements and provider performance initiatives, including Stars, HEDIS, compliant risk adjustment, medical cost, quality, access and member experience, through education, data exchange, action planning and performance tracking.
• Coordinates assigned regulatory and compliance activities, including provider attestations, Model of Care training, delegated oversight, accreditation or audit requests and corrective-action follow-up.
• Leads defined initiatives or assigned portions of larger projects, maintaining plans, responsibilities, deadlines and decisions and escalating barriers when needed.
• Maintains complete and timely provider account, contracting, issue and outcome records in designated systems; report risks and complete assigned mitigation actions.
• Applies feedback and developing knowledge of managed care, reimbursement and provider performance to take on increasingly complex provider work.
• Exercises judgment with general supervision for lower-complexity provider work. Resolves day-to-day provider matters and agrees to operational resolutions, implementation plans, education and corrective actions within assigned authority.
• Leads straightforward negotiations using approved parameters and escalates nonstandard terms, significant risks and decisions outside delegated authority.
• Remains accountable for assigned provider relationships through contracting, implementation and ongoing service, including timely follow-through when work depends on other departments.
• Participates in special projects and performs other duties as assigned.

Kenntnisse

Provider relationship management

Contract negotiation

Ausbildung

Bachelor's degree

Jobbeschreibung

VNS Health in New York seeks a provider relations professional to manage a lower-complexity portfolio, serve as the primary contact for service, recruitment, contracting and issue resolution, and escalate higher-risk matters.

You will lead onboarding, coordinate implementations, support value-based payment initiatives, and maintain records while expanding capabilities with supervision. The role offers opportunities for growth within a large, mission-driven health system in the New York area.