Network Development Representative

POSITION SUMMARY

The Network Development Representative is responsible for the development, expansion, and maintenance of our preferred provider network. This role simplifies and optimizes the payor/provider relationship by operating as the liaison and primary point of contact for servicing, issues, questions, needs, etc.

NATURE AND SCOPE

• This role reports to: Director of Provider Networking
• This position does not manage people
• Job status: Full-time (40 hours/week)
• FLSA: Exempt
• Role requires weekly travel with possibility of overnight stays

QUALIFICATIONS

Education

• Bachelor’s degree in business administration, marketing, or related field preferred
• Four years of related experience may be used in lieu of bachelor’s degree

Work Experience

• Experience in a healthcare-related position such as provider relations, network management, contracting, credentialing, etc.
• Experience working in health insurance required
• Payor and/or provider experience required
• Experience can run concurrently

Knowledge, Skills, and Abilities

• Exceptional interpersonal skills and professionalism with ability to interact effectively across a wide range of individuals including physicians, office staff, hospital executives, other healthcare professionals, and internal team members
• Knowledge of healthcare systems and payer-provider dynamics with ability to negotiate and contract with healthcare providers
• Knowledge of CMS rules and regulations
• Ability to navigate through multiple computer applications and programs with ease including but not limited to Microsoft Office Suite (Word, Outlook, Excel, PowerPoint, etc.)
• Exceptional written and verbal communication skills
• Self-accountable, organized, and efficient with strong attention to detail and ability to meet deadlines and excel under pressure
• Highly adaptable and agile with effective time-management skills and ability to multitask and prioritize in a fast-paced, ever-evolving environment

Licenses and Certifications

• Must have and maintain a valid driver's license, clean driving record, and reliable transportation
• Health insurance broker license preferred

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

• Identify, recruit, and contract with healthcare providers, including physicians, specialists, hospitals, and ancillary service providers
• Conduct research and analysis to develop provider recruitment strategies and identify opportunities for network expansion that meet network adequacy requirements
• Facilitate onboarding process for new providers and ensure they meet all necessary qualifications and regulatory requirements
• Foster and maintain productive relationships with prospective providers through regular contact and communication
• Maintain high level of visibility and engagement with providers through strategic schedule planning and clearly defined objectives and outcomes for each visit; minimum field travel is 3 days per week
• Maintain accurate weekly log of all activity
• Provide roster management and demographic form completion with accuracy
• Negotiate contracts with healthcare providers focused on terms that promote high-quality care and cost-effectiveness
• Deliver high level of internal and external service to resolve provider issues and complaints
• Develop and provide ongoing training and education to providers on billing procedures and other relevant policies
• Maintain detailed record of all visits
• Represent the organization at community events, etc. to maintain high level of visibility and engagement in markets
• Other duties as assigned

Physical Requirements

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to satisfactorily perform these essential functions without causing an undue hardship for the employer.

• Remain in a stationary position for prolonged periods of time, often standing or sitting at a desk and working on a computer
• Perform functions requiring repetitive motions that may include wrists, hands, and/or fingers
• Regularly communicate with others via phone, email, etc., and move about the workspace to accomplish tasks
• Occasionally move objects up to 50 pounds

Job Type: Full-time

Pay: $40,000.00 - $90,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: Hybrid remote in Monroe, LA 71201

Salary : $40,000 - $90,000