Provider Relations Specialist-Hospitals (Full Time, Remote, North Carolina Based)

Alliance Health•Fayetteville, NC

4d•$29 - $38•Remote

About The Position

The Provider Relations Specialist is responsible for maintaining a strong and stable provider network by facilitating key recruitment related activities for existing services and maintaining positive, ongoing relationships with health care providing entities. This position will focus on hospitals, hospital systems, and other facilities to cultivate new provider relationships and provide ongoing provider support. This position will allow the successful candidate to work a schedule that will be primarily remote. Must reside in NC in the event there are in-person meetings at provider/hospital locations or one of the Alliance office locations.

Requirements

Bachelor’s degree in a Human Services field from an accredited college or university and three (3) years progressive post-degree experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health; OR Master’s degree in Human Services from an accredited college or university with one (1) years post graduate experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health.
Knowledge of recruiting healthcare providers; negotiating and managing contracts with hospitals, hospital systems, ancillary groups, facilities, and/or physicians
Knowledge of establishing and maintaining relationships with large and/or complex systems
Knowledge of providing technical assistance related to contract terms, billing and reimbursement (claims), and managed care
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 independent 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

Responsibilities

Manage assigned recruitment projects and resources
Collaborate with Provider Relations team and create strategies for meeting network growth
Assist in recruiting and retaining qualified and capable hospitals, ancillary groups, facilities, and physicians
Plan and execute daily recruitment call schedule and approach
Use various network reports, including network adequacy, etc., to identify network gaps in existing assigned networks and recruit hospitals, ancillary groups, facilities, and physicians so networks remain competitive and compliant with state and federal regulations
Track and report on recruitment interactions and cycle stages using various application tracking mechanisms on a regular basis
Compile internal data to determine network needs and to increase network
Maintain professional relationships with hospitals, ancillary groups, facilities, and physicians
Act as the point of contact for hospitals, ancillary groups, facilities, and physicians
Provide technical assistance to assigned hospitals, ancillary groups, facilities, and physicians
Participate in assigned committees and in meetings to provide ongoing feedback using market conditions, industry trends, and provider insights
Provide technical assistance and customer service to network hospitals, ancillary groups, facilities, and physicians; other departments; and external stakeholders. This could include researching and troubleshooting issues, collaborating with other departments
Participate in or facilitate Joint Operating Committee meetings with hospitals/hospital systems or other facilities
Research, identify, and negotiate contracts as needed within established timelines to support access to services. This may involve collaboration with legal and finance departments and senior and executive leaders
Be knowledgeable of assigned provider contracts with hospitals, ancillary groups, facilities, and physicians in conjunction with Alliance’s Finance and Contract departments
Develop and manage scopes of work for hospitals, ancillary groups, facilities, and/or physicians
Collaborate and communicate effectively with other Departments and/or with hospitals, ancillary groups, facilities, and physicians to follow up on any issues and provide outreach or education