Director of Provider Development

2 weeks ago

Indianapolis, United States CareerBuilder Full time

Provider Partners is searching for a results-oriented individual, with a proven track record, who is passionate about our mission and can generate positive outcomes based on that mission. The Director of Provider Development & Contracting plays a pivotal role in managing and developing relationships with healthcare providers within our network. This position is responsible for ensuring a high level of provider satisfaction and service while optimizing network performance and strategy.
Key Responsibilities:

Provider Relationship Management:
Serve as the primary contact for healthcare providers.
Maintain and enhance strong, long-term relationships with providers.
Address and resolve provider inquiries and concerns in a timely and professional manner.
Conduct provider orientations and provide ongoing education on PPHP policies, procedures, and new initiatives.
Network Development and Management:

Identify, recruit, and contract with new providers to expand our network.
Negotiate contract terms, rates, and agreements with providers.
Analyze network performance, identify gaps, and recommend improvements.
Work collaboratively with internal teams to ensure network adequacy and to develop network strategies.
Performance Monitoring and Reporting:

Monitor provider performance metrics and ensure compliance with contractual and regulatory requirements.
Prepare and present network performance reports to senior management.
Evaluate provider satisfaction and recommend strategies for improvement.
Compliance and Regulatory Adherence:

Ensure provider compliance with state, federal, and PPHP regulations and standards.
Stay abreast of changing regulatory requirements and ensure timely communication to providers and internal stakeholders.
Project Management:

Lead and participate in cross-functional projects aimed at improving network performance and provider satisfaction.

Qualifications:

Bachelors degree in healthcare administration, business, or related field required; Masters degree preferred.
Minimum of 5-10 years of experience in healthcare network management or provider relations in the state of Indiana.
Strong knowledge of healthcare industry, contract negotiations, and regulatory compliance.
Excellent communication and interpersonal skills with the ability to build strong relationships with providers and internal teams.
Strong analytical and problem-solving skills.
Ability to manage multiple priorities in a fast-paced environment.
Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).

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