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.
Responsibilities & Duties
Recruit Providers to Ensure an Aequate Network of Providers
- 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
Develop and Maintain Relationships with Hospitals, Ancillary Groups, Facilities, and Physicians
- 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
Contract Responsibility
- 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
- 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
Minimum Requirements
Education & Experience
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, Skills, & Abilities
- 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
Salary Range
$28.96 - $37.65/ Hourly
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
- Medical, Dental, Vision, Life, Long Term Disability
- Generous retirement savings plan
- Flexible work schedules including hybrid/remote options
- Paid time off including vacation, sick leave, holiday, management leave
- Dress flexibility
