Logo for Workplace Options

Network Sourcing and Development Specialist

Key Facts

Remote From: 
Full time
English

Other Skills

  • Computer Literacy
  • Quality Assurance
  • Microsoft Word
  • Report Writing
  • Relationship Management
  • Public Speaking
  • Professionalism
  • Non-Verbal Communication
  • Cooperation
  • Assertiveness
  • Telephone Skills
  • Organizational Skills
  • Goal-Oriented
  • Social Skills
  • Problem Solving

Roles & Responsibilities

  • Bachelor's degree in a related field
  • At least three years of provider relations experience, preferably in PPO/HMO or similar setting
  • Experience in managed care/PPO environments with familiarity in rate negotiations
  • Excellent written and oral communication skills and strong problem-solving/organizational abilities

Requirements:

  • Develop, expand, and maintain the PPO network, including provider identification, solicitation, and rate negotiation
  • Negotiate PPO rates and ensure adherence to provider fee schedules; coordinate rate negotiations with VP, Provider Relations and VP, Finance
  • Assist in provider orientations and act as liaison with treatment providers, clients, patients, and others to resolve problems in a timely manner
  • Support Clinical Division and other departments on client contracts and proposals; participate in marketing/provider relations efforts and maintain/update policies as appropriate

Job description

About this opportunity:

Workplace Options is proud to support our sister organisation, Behavioral Health Systems (BHS), in recruiting a Network Sourcing and Development Specialist. If you’re passionate about building strong provider networks and making a real impact, this is your chance to be part of something meaningful and transformative.

BHS operates one of the nation’s largest specialty preferred provider organizations (PPO), which is comprised of psychiatrists, psychologists, social workers, EAP providers as well as facility networks including hospitals, rehab/residential treatment centers, partial hospitalization programs and intensive outpatient programs. BHS fully credentials and panels their own network of providers.


Current Opportunity: Network Sourcing and Development Specialist

Location: US

Full-time/Part-time: This is a full-time (40 hours per week) position. 

What you will do:

Reporting to the Vice President, Provider Relations, this position is responsible for continued development of PPO network, PPO rate negotiations, and orientation of providers. 

Responsibilities:
  • 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 Vice President, Provider Relations and Vice President, Finance.
  • Assist in conducting BHS provider orientations, to include individual and regional provider training sessions, as requested.
  • Serve as liaison with treatment providers, clients, patients, and others, as requested. Resolve  problems on a timely basis.
  • Provider Relations Division serves in direct support role to the Clinical Division. Assist Clinical Division as directed in client/case-specific provider hook-ups and problem-solving.
  • Assist Clinical Division and Accounting/Marketing Divisions as requested in support services related to specific or potential client contracts. Assist in preparation of proposals as requested.
  • 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.
  • Participate in on-going marketing and provider relations efforts, as directed. Participate in special projects, on-going research and public relations efforts as appropriate. Coordinate information on competition, provider rates by region or city, national statistics and relevant changes in the field with Vice President, Provider Relations. Make recommendations on product line enhancements. Prepare reports as requested.
  • Perform other related duties as directed or deemed appropriate. Attend meetings as requested. Advise Vice President, Provider Relations on developments in the field.

Qualifications/Skills:
  • 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.

For further information about BHS please see https://behavioralhealthsystems.com/providers/ 

Workplace Options collects and processes personal data in accordance with applicable data protection laws. If you are a European job applicant, refer to our Privacy Notice for further details (https://www.workplaceoptions.com/privacy-notice-for-recruitment/).

Network Systems Engineer Related jobs

Other jobs at Workplace Options

We help you get seen. Not ignored.

We help you get seen faster — by the right people.

🚀

Auto-Apply

We apply for you — automatically and instantly.

Save time, skip forms, and stay on top of every opportunity. Because you can't get seen if you're not in the race.

AI Match Feedback

Know your real match before you apply.

Get a detailed AI assessment of your profile against each job posting. Because getting seen starts with passing the filters.

Upgrade to Premium. Apply smarter and get noticed.

Upgrade to Premium

Join thousands of professionals who got noticed and hired faster.