Network Recruitment and Development Specialist

Responsibilities

• Develop, expand and maintain PPO network, to include new provider identification, solicitation and rate negotiation.
• Adhere to established provider fee schedules.
• Cook up and present 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.
• Assist Clinical Division as directed in client/case-specific provider hook-ups and problem-solving.
• Aid Clinical Division and Accounting/Marketing Divisions as requested in support services related to specific or potential client contracts.
• Prepare 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.
• 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.
• Attend meetings as requested.
• Advise Vice President, Provider Relations on developments in the field.

Qualifications

• Bachelor's degree 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.

Benefits

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