Associate Network Director | Dedicated Senior Medical Center
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Associate Network Director

  • R0005841
  • Arlington
  • November 20, 2018

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Job Description
ESSENTIAL JOB FUNCTIONS:
The Network Manager is responsible for managing specialist network by maintaining and developing South Florida areas. Provides service and education to network specialists. Achieves company targets through the implementation of network improvement plans. Works in conjunctions with the Network Director.
Primary Duties and Responsibilities:
  • Building & Maintaining effective long-term relationships and high level of satisfaction with key specialists.
  • Conducts site visits to service providers, resolve issues, educate staff/providers on policies and certify specialists.
  • Identify network gaps.
  • Supports Network development by providing utilization reports, pharmacy profiles, ER contingencies, Frequent Flier Reports and other analytics available to improve/maintain outcomes.
  • Identifies root cause of problems and trends and participates in developing solutions.
  • Works with Provider's staff and organization staff to resolve the issue and monitor recurrence.
  • Special projects as assigned or directed.
  • Strategizes for membership growth and retention.

KNOWLEDGE, SKILLS AND ABILITIES:
  • Excellent influencing and negotiation skills.
  • Ability to explain complicated financial terms and utilization data to physicians/staff.
  • Excellent written, verbal and public speaking skills.
  • Advanced MS Word and Excel.
  • Ability to understand, interpret and communicate all types of provider and regulatory contracts.

EDUCATION / SPECIALIZED KNOWLEDGE REQUIREMENTS:
  • Bachelor's degree.
  • Three years Provider Relations experience or similar background.
  • Pharmacy, healthcare, or provider relations experience.

PHYSICAL REQUIREMENT

PRIMARY DUTY

Percent of Time doing Activity



0%-24%
Seeing: Must be able to read screen & various reports
Yes

Hearing: Must be able to hear well enough to communicate
Yes

Standing / walking
No

Climbing / kneeling/bending
No
X
Lifting / pulling / pushing
No
X
Grasping / feeling: Must be able to write, type, and use phone
Yes

Disclaimer
Reviewed by:
Catalina Rodriguez-Edwards
Approved by:
Shaniqua Smith
REVISION DATE:
September 25, 2015
Additional Job Description

EDUCATION AND EXPERIENCE CRITERIA:

  • Bachelor’s degree required, Masters preferred.
  • Minimum Ten (10) years building national provider networks.
  • Minimum (5) years of management experience.Experience in working with Insurance, Health Plans companies, and/or Independent Medical Clinics.
  • Experience working in the healthcare industry.
  • Experience in contract negotiation.
  • Experience in clinical recruiting.

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