Provider Network Specialist

Birdsong Hearing Benefits•,

2d•$72,000 - $82,000•Remote

About The Position

The role of Provider Network Specialist is a key role for Your Hearing Network (YHN). This role is essential to ensure the highest quality of provider relationships within the network. The role reports to the Director Provider Relations. As a Provider Network Specialist for YHN, this strategic role plays a crucial part in ensuring our members have access to high-quality hearing care services. This position focuses on ensuring that existing providers are well-supported. This role will maintain ongoing relationships with network providers, address any concerns and ensure proper compliance with company policies, NCQA standards, and industry regulations.

Requirements

Three (3) years’ experience preferred in provider relations.
Experience working with healthcare providers, understanding their needs, and building strong relationships.
Familiarity with managed care principles is valuable.
Strong verbal and written communication skills.
Demonstrate an entrepreneurial spirit, managing change well, and being flexible to environment.
Comfortable calling providers on issues and concerns.
Willingness to go above and beyond daily to achieve best-in-class results.
Ability to work with highly detailed, complex, and emotionally sensitive information.
Ability to maintain a high degree of discretion, confidentiality, protection, and integrity.
Ability to prioritize and complete multiple complex work assignments.
Ability to work independently and in groups.
Excellent written and verbal communication skills.
Ability to provide and receive constructive feedback in a clear, concise, and respectful manner.
Demonstrate ability to meet deadlines.
Basic knowledge of data analysis, statistics, data integrity, and analytics with initiative and ability to further develop skills.
Reliable and secure Internet Service Provider at home (no public WiFi) for duration of working hours
Sufficient room to set up a laptop, monitors, keyboard and mouse
Comfortable space to work for duration of working hours
Quiet, private and secure space in which to work

Responsibilities

Establish and maintain relationships with hearing care providers, including audiologists, ENT specialists, and hearing aid dispensers.
Monitor provider performance and service quality to ensure adherence to organizational standards and patient care expectations.
Serve as the primary point of contact for network providers, addressing their inquiries and resolving any issues.
Provide training and support to providers on organizational policies, procedures, and systems.
Coordinate with providers to ensure timely and effective communication regarding network updates and changes.
Collect, analyze, and report on data related to network performance, provider metrics, and patient outcomes.
Maintain accurate and up-to-date records of provider information, agreements, and performance evaluations.
Ensure that network providers comply with relevant regulations, accreditation standards, and best practices in hearing care.
Conduct regular audits and evaluations of provider services and facilities to ensure high-quality care.
Address any compliance issues promptly and work with providers to implement corrective actions.
Work closely with internal teams, including clinical, operations, and customer service, to align network strategies with organizational goals.
Collaborate with internal stakeholders, to enhance network capabilities and patient access to care.
Prepare and present regular reports on network performance, provider metrics, and strategic initiatives to senior management.
Document network activities, provider interactions, and key performance indicators to support continuous improvement efforts.

Benefits

Medical, dental, prescription, and vision benefits
24/7 virtual medical care
Employee Assistance Program for you and your family
401(k) with company match
Company-paid life insurance
Supplemental insurance for yourself, your spouse/partner, and your children
Short-term and long-term disability insurance
Pre-tax Health Savings Account and Flexible Spending Accounts for Health Care or Dependent Care
Pet Insurance
Commuter accounts