Provider Network Specialist

Job Summary

Required Qualifications

• •Three (3) years' experience in provider relations and/or provider recruitment
• •experience working with healthcare providers, understanding their needs, and building strong relationships
• •Strong verbal and written communication skills
• •familiarity with managed care principles
• •Basic knowledge of data analysis, statistics, data integrity, and analytics with initiative and ability to further develop skills
• •Demonstrate high proficiency skills in MS Office applications
• •Negotiation Skills: Provider Network Specialists often negotiate contracts with healthcare providers. Strong negotiation skills are vital
• •Communication and Relationship-Building: Excellent communication skills are necessary for collaborating with providers, addressing concerns, and maintaining positive relationships
• •Relationship Building: Ability to establish and maintain strong relationships with providers and internal stakeholders
• •Strategic Thinking: Ability to develop and execute strategies to grow the provider network effectively
• •Attention to Detail: Ensure all provider agreements and compliance requirements are thoroughly reviewed and met
• •Problem-Solving: Capable of identifying issues and implementing solutions promptly
• •Multi-Tasking: Provider Network Specialists handle various responsibilities simultaneously, so effective time management and multitasking abilities are essential
• •Collaborative Mindset: Success in this role depends on working well with cross-functional teams, including claims, customer service, and management
• •Problem-Solving: Ability to address challenges related to network performance, member complaints, and provider satisfaction
• •Member-Centric Focus: Always keep the well-being of our members at the forefront
• •Innovation: Be flexible and nimble, slight changes can have a large effect -- work smarter, not harder
• •Team: We are better together, celebrate our successes, learn from our mistakes, we all help each other develop and grow through open dialogue and feedback, our efforts are interconnected, and our diversity makes us stronger
• •Accountability: To oneself and others, you positively affect someone's life, you hold yourself and your team accountable, find learning moments in every experience

Desired Qualifications

• •Three (3) years' experience preferred in provider relations and/or provider recruitment
• •Preferred experience in provider contracting and negotiations
• •familiarity with managed care principles is valuable
• •Experience with software used for network growth is preferred
• •Bachelor's degree in healthcare administration, or related field is preferred. Equivalent work experience will be considered in lieu of a degree
• •Demonstrate an entrepreneurial spirit, understanding start-up requirements, managing change well, and being flexible to environment
• •Willingness to go above and beyond daily to achieve best-in-class results
• •Ability to work with highly detailed, complex, and emotionally sensitive information
• •Ability to maintain a high degree of discretion, confidentiality, protection, and integrity
• •Ability to prioritize and complete multiple complex work assignments
• •Ability to work independently
• •Excellent written and verbal communication skills
• •Ability to provide constructive feedback in a clear, concise, and respectful manner
• •Demonstrate ability to meet deadlines