Network Development Specialist

Under the direction of the VP, Provider Relations, and in cooperation with all divisions as deemed appropriate:

 

1. 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 EVP/CQO and Sr. Vice President, Finance.              

 

 

3. Serve as liaison with treatment providers, clients, patients, and others, as requested.  Resolve problems on a timely basis.

 

4. Provider Relations Division serves in a direct support role to the Clinical Division.  Assist Clinical Division as directed in client/case-specific provider hook-ups and problem-solving.

 

5. Assist Clinical Division and Accounting/Marketing Divisions as requested in support services related to specific or potential client contracts.   Assist in the preparation of proposals as requested.

 

6. 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.

 

7. Participate in ongoing marketing and provider relations efforts, as directed.  Participate in special projects, ongoing research, and public relations efforts as appropriate.  Coordinate information on the competition, provider rates by region or city, national statistics, and relevant changes in the field with EVP/CQO.  Make recommendations on product line enhancements.  Prepare reports as requested.

 

8. Perform other related duties as directed or deemed appropriate.  Attend meetings as requested.  Advise EVP/CQO, on developments in the field.

 

Qualifications:

 - Bachelors in related field.  

 - Three years provider relations experience required, preferably with PPO/HMO or   similar setting.

 - Experience in managed care/PPO environment.

 - Some experience/involvement in mental health field and public relations preferred.

 - 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.

- Experience in group presentations/speaking preferable.

- Excellent problem-solving abilities.

 - Willing to perform extensive telephone work.

 - Professional appearance.

- Cooperative attitude and self-starter.  Assertive.  Goal-oriented.

 - Dependable transportation.