Managed Care Specialist
Duration : Full Time / Permanent
Location : Remote
Summary
The Network Development Specialist is responsible for growing the network nationwide by adding new PT providers that offer Workers Comp services to injured workers. This position will be the point of contact to negotiate contract terms that satisfy all internal and external obligations, including State mandates.
Potential network providers are contacted based on several factors that improve footprint, geographical coverage and outcomes to injured workers
Responsibilities:
• Research and recruit potential providers for current and new product lines.
• Monitor and ensure that follow-up on recruited providers happens in a timely fashion.
• Timely documentation of recruitment status and efforts in designated tracking system.
• Work with other Network Specialist s to aggressively move potential providers toward participation with the network.
• Strategic identification for potential providers based on client s needs.
• Heavy telephonic recruitment/contact with providers.
• Assist Manager in strategic development and achievement of monthly/annual goals.
• Work with all teams within Provider Management for requests on adding new services, questions about contracts or work on leads from Account Management or Patient Advocacy Team.
• Strictly adheres to all aspects of our client’s Confidentiality, Privacy and Security Standards Policies and Confidentiality Operating Procedures in performing work.
Qualifications :
• 4-year degree, or equivalent education and experience
• Prior experience in a medical (PPO, HMO, Provider Network), insurance or sales oriented recruitment environment is required for this position
• Excellent communication, negotiations, organizational, and problem solving skills
• Documentation, listening and phone skills
• Initiative and the ability to troubleshoot and resolve conflict
Microsoft Office Skills (Word, Excel, PowerPoint, Outlook)
