Network Sourcing and Development Specialist

Workplace Options

3d

About The Position

Workplace Options is proud to support our sister organisation, Behavioral Health
Systems (BHS), in recruiting a Network Sourcing 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.

Requirements

• Bachelors in related field.
• Three years provider relations experience required, preferably with PPO/HMO or similar setting.
• Experience in managed care/PPO environment.
• 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.
• 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.

Nice To Haves

• Some experience/involvement in mental health field and public relations preferred.
• Experience in group presentations/speaking preferable.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level