Provider Network Recruiting & Development Specialist - Network Business Development, SWHR at Southwestern Health Resources CIN in Pittston, Pennsylvania
Posted in General Business 30+ days ago.
Type: Full-Time
Job Description:
Provider Network Recruiting & Development Specialist
Network Business Development
Southwestern Health Resources, a national leader in population health, is looking for a qualified Provider Network Recruiting & Development Specialist to join our Network Business Development team.
If you're looking for a rewarding career at a patient-centered organization with work-life balance and comprehensive benefits, we want to hear from you.
Position Highlights
Work location: Southwestern Health Resources Headquarters, 1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234
Work environment: Network Business Development.
Please note: The Provider Network Recruiting & Development Specialist will be an employee of Southwestern Health Resources (SWHR). SWHR is a clinically integrated network formed by Texas Health Resources and University of Texas Southwestern Medical Center.
Work hours:
- Full-time, 40 hours per week.
- Monday - Friday, Day shift.
- This is a telework position, however, may require onsite workdays in a week, based on department business needs.
- May require in-person attendance as needed, to department meetings, trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.
- May require occasional local travel within the Dallas/Fort Worth Metroplex, based on department business needs.
The SWHR Network includes physicians from University of Texas Southwestern Medical Center and Texas Health Resources, as well as more than 2500 independent community Primary and Specialty Care Physicians. In partnership, our team implements physician-driven, value-based care strategies to coordinate care for more than 700,000 patients, across 16 counties in North Texas, resulting in lower costs and high-quality care.
In 2020, the Centers for Medicare & Medicaid Services (CMS) released the annual financial and quality results. Based on the report, SWHR is one of the nation's leading Next Generation Accountable Care Organizations (ACO), having saved nearly $120 million since joining the program in 2017.
SWHR is the parent organization of Care N' Care Insurance Co., a leading regional Medicare Advantage health plan organization that serves approximately 17,000 patients in North Texas.
Education
- Bachelor's Degree in Business, Finance or a related field required.
- Bachelor's Degree in Healthcare and/or a Clinical field highly preferred.
Experience
- Require 2 years of relevant provider contracting experience with prior demonstrated success in provider contracting with both large physician groups and ancillary providers.
- Require 3 years of experience in performing network adequacy analysis.
- Require in-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) with at least an intermediate level of knowledge of claims processing systems and guidelines.
- Experience in physician relations, physician network/business development, physician recruitment and assimilation preferred.
- Experience and knowledge of integrated delivery network, Accountable Care Organization (ACO) and/or Value-Based Healthcare organization functions highly preferred.
Skills & Abilities
- Must be proficient in relevant computer applications such as Microsoft Office.
- Must be detail oriented.
- Must be dependable, exhibit strong initiative, and be self-motivated.
- Must possess excellent communication skills.
- Must be able to frequently problem solve, make decisions, interpret data, organize and analyze workflow, write, plan, and use simple arithmetic.
- Sales Force experience helpful.
This position negotiates, re-negotiates, and executes physician, ancillary and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. The position is also designed to maintain and update provider data in various departmental systems.
Position Functions
- Negotiate and re-negotiate high-volume, transactional-style physician and ancillary contracts. Function as the single point-of-contact for all on-going contractual and service issues as needed by providers.
- Facilitate provider education, training them in order to increase their familiarity and satisfaction with systems and strategies.
- Create trend analyses and summaries for decision-making purposes.
- Interface with market leaders to align contracting needs and business efforts.
- Set targets and priorities in order to department and company goals and objectives.
As a Southwestern Health Resources employee, you'll enjoy, comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.
Additional perks of being an SWHR employee:
- Gain a sense of accomplishment by contributing to a teamwork environment.
- Positively impact patients' quality of life.
- Receive excellent mentorship, comprehensive training and dedicated clinical and administrative leadership resources.
- Enjoy opportunities for growth.
Our Recruitment team invites you to contact us with any questions at recruitment@texashealth.org
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