What are the responsibilities and job description for the PPO Network Development Specialist position at Express Employment Professionals - Birmingham, AL South?
Network Development Specialist
Pay Rate : $62,000 - $65,000 plus incentives
Summary :
A local Birmingham, AL based mental health managed care provider is seeking a Network Development Specialist to join their team to assist with the continued development of their PPO network. Under the general direction of the Vice President of Provider Relations, the Network Development Specialist is responsible for expanding and maintaining the PPO network, negotiating provider rates, and conducting provider orientations.
Key Responsibilities :
- Develop, expand, and maintain the PPO network, including identifying and soliciting new providers and negotiating rates. Ensure adherence to established provider fee schedules and coordinate rate negotiations with leadership.
- Conduct provider orientations, including individual and regional training sessions, as needed.
- Serve as a liaison between treatment providers, clients, patients, and other stakeholders to resolve issues promptly.
- Support the Clinical Division with client / case-specific provider coordination and problem-solving.
- Assist the Clinical, Accounting, and Marketing Divisions in support services related to client contracts, including proposal preparation.
- Maintain and recommend updates to corporate, departmental, and quality assurance policies and procedures. Suggest revisions to PPO contract forms and rates as needed.
- Participate in marketing, provider relations efforts, and special projects, including market research, public relations initiatives, and competitive analysis. Provide recommendations for product line enhancements and prepare reports as requested.
- Perform other duties as assigned and keep leadership informed of industry developments.
Qualifications :
Salary : $62,000 - $65,000
