Regional Network Specialist

American Imaging Management is the leading provider of diagnostic imaging services in the U.S. Our Provider Relations team is seeking qualified candidates to assist in the management of our midwest clients.
Provider Relations:
1.Develops and maintains communication with providers to facilitate provider network success (e.g. program design, assessment, contracting and financial performance). Proactively visits key provider sites on a regular basis, maintaining current provider data status, educational needs, and service issues. Works directly with account management and internal provider services representatives to triage research, claims reconciliation projects, and other data analyses as needed.
2.In conjunction with internal provider relations representative, development and implementation of provider communication and training materials, reference and communication materials to support appropriate network utilization and compliance, along with monitoring service indicators such as access, satisfaction, complaint, and education tracking programs.
3.Contract preparation and implementation, financial analysis and rate proposal development, and in depth knowledge of various reimbursement methodologies.
4.Market company’s online tool sets and educate/train providers in assigned territories on the use of those tools.Contracting:
1.Acts as accountable lead for initiating and driving provider contracting efforts in assigned region.
2.Works with department management on negotiating rates and guidelines for key provider contracts.
3.Manages contracting communications and workflow from initiation through signature.
Project Management:
1.Project work and responsibilities as required. Complete special projects that are identified through regional account management, provider relations, and/or AIM management.
2.Assist in managing program implementations.
3.Support implementation of program design changes by working with the Regional Account Executive, on client-based service needs.
4.Provide administrative and planning support for Account Manager to operate Local Imaging Advisory Council (LIAC), which meets periodically to discuss diagnostic imaging clinical issues.
REQUIREMENTS
Education: Bachelor’s Degree required.
Experience: 3 to 5 years health care experience. Prefer prior HMO, IPA/PHO or provider relations experience. Medical service program experience with insurers and/or project management experience a plus.Knowledge: Microsoft Word and Excel. Strong time management skills
Should you chose to join our team, you will enjoy a competitive benefits package including health, dental, vision, life, disability, 401(k) and more!
Related Keywords:Provider Relations, Managed Care, Network Management, Contracting