Provider Relations Acct. Executive

Seeking individual responsible for the development of a quality and cost effective Provider Network that meets the needs of Long Term Care Diversion members. Responsibilities include: identifying providers, negotiating contracts, processing and maintaining provider contracts, provider support, and monitoring. The position takes a proactive approach in developing and meeting company needs and expansion goals in a timely manner. Assist with community outreach by building relationships with providers and community representatives, making presentations and participating in community functions. LOCATIONS: South Florida ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Develop and maintain a comprehensive provider network for the long term care program. Negotiate contracts that promote membership growth, cost effectiveness and quality delivery of services. Maintain timely communication with providers and community organizations. Coordinate and resolve provider issues in a timely manner. Ensure licensure and required provider information is current in coordination with Credentialing Department. Assist in meeting department goals. Train providers on procedures and requirements. Prepare timely and accurate reports and provider directory. Make contact with community representatives and build relationships. Make presentations. Arrange and successfully execute community outreach events including health fairs and other events that promote the organization. Drive to various sites in multiple counties. SUPERVISORY RESPONSIBILITIES include the following: N/A QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Experience in provider contracting and/or provider relations Experience in marketing or community outreach preferred Knowledge of Medicaid and Medicare programs Excellent organizational skills Strong writing skills Excellent presentation, communication and interpersonal skills Solid computer skills EDUCATION and/or EXPERIENCE Bachelor's degree preferred or two years experience in managed care / health care. CERTIFICATES, LICENSES, REGISTRATIONS Valid Florida driver's license SF50008760
REQUIREMENTS
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