Provider Network Service Development Specialist (Full-time Remote, North Carolina Based)

Alliance Health•Fayetteville, NC

4d•$69,592 - $88,729•Remote

About The Position

The Provider Network Service Development Specialist supports the development and management of the Provider Network, including assisting with the expansion of current services, development of new services, and recruiting providers to fulfill network needs. This position will assist with Alliance’s networks gaps and needs analysis to help ensure Alliance Health has an adequate provider network. This position will also assist in the coordination of cross-departmental initiatives, identified internally or by the State of NC and assist in the oversight of Provider Network activities related to special initiatives, with a focus on network adequacy, current services expansion and new service implementation. This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel to one of the offices for business or onsite team meetings as needed. Occasional provider site visits may be required within 100 mile radius of Alliance home office.

Requirements

Bachelor’s degree in a Human Services field from an accredited college or university and five (5) years progressive post-degree experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health
Master’s degree in Human Services from an accredited college or university with three (3) years post graduate experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health
Knowledge of Alliance’s goals, targets, and outcomes in relation to the responsibilities of the Provider Network Operations department
Knowledge of all disability areas including Mental Health, Substance Use and Developmental/Intellectual Disabilities
Knowledge and understanding of principles, concepts, and Best Practices used in the treatment, habilitation and support of individuals with needs in any of the disability areas
Knowledge and understanding of the different systems that impact Providers
Microsoft Office suite, including Excel
Proficient with database maintenance
Exceptional interpersonal skills
Highly effective Communication skills
Problem solving skills
Organizing skill
Conflict resolution skills
Effective public speaking and training skills
Strong mediation skills in order to facilitate collaboration and positive relationships
High Level of diplomacy and discretion to effectively negotiate and resolve issues independently
Ability to build relationships
Ability to make prompt decisions based upon relevant facts
Ability to review and analyze data in an effort to evaluate program effectiveness, progress, problems, and system performance
Ability to work effectively with others internally and externally
Ability to effectively identify problems, and initiate solutions
Ability to take initiative and utilize critical thinking

Nice To Haves

Previous Provider Network experience
Previous Project Management experience
Previous Network Adequacy analysis experience and development of new services and programs
Licensure and/or certification in area served is preferred

Responsibilities

Assess current network adequacy and recommend expansion of current services to address gaps in the service array
Research current services that need expansion
Assist in recruiting and retaining qualified and capable providers to assist in the expansion of current services
Analyze funding incentives and disincentives for best practices
Identify and recommend new services and supports to address gaps in the service array
Research new services identified
Assist in recruiting and retaining qualified and capable providers to provide new services
Analyze funding incentives and disincentives for best practices
Review and approve the addition of new services to existing providers
Develop Scopes of Work (SOW) and lead the process to finalize the SOW and gain approval
Ensure all programs, services, and systems are developed in accordance with Local, State and Federal Performance Standards, and congruent with Alliance organizational and procedure manuals
Assist in the identification and coordination of internal and external training needs as it relates to new service development and or current service expansion
Develop and lead new Provider Collaboratives related to new service, current service expansion or pilot project implementation
Ensure that Evidence Based and Best Practice services for consumers are in place as identified and are available for consumers
Assist, guide and support providers in the development and maintenance of comprehensive, outcome focused consumer services
Be knowledgeable of assigned provider contracts with agencies and organizations in conjunction with Alliance’s Finance and Contract departments
Provide technical assistance and feedback for the use of local and state funds, new service delivery and adherence to best practice standards and contractual requirements
Collaborate directly with Alliance Health Provider Network Leadership to review network adequacy data to help identify and expand current services
Arrange and facilitate interdepartmental, provider and State personnel workgroups
Represent Alliance on State Committees, as applicable
Assist in the coordination of cross-departmental Initiatives as identified
Establish and maintain relationships and collaborations with relevant public, private, and provider agencies, in order to assure open communications, avoid misunderstanding and support solution focused atmosphere within the community
Participate in the creation of and attend and or lead newly created Provider Learning Collaboratives
Evaluate Out of Network requests based on Network capacity and approve or deny requests
Partner with Health Care Project Management Team, Claims, Business Operations, Medical Management, and other areas to address ongoing needs and develop solutions