Director Provider Network Management- Bakersfield 1.1

Description

Location: Bakersfield, CA (Onsite)

Classification: Full-Time

This position is exempt and will be paid on a salaried basis.

Schedule: Monday-Friday 8am-5pm

Benefits

• Medical
• Dental
• Vision
• Paid Time Off (PTO)
• Floating Holiday
• Simple IRA Plan with a 3% Employer Contribution
• Employer Paid Life Insurance
• Employee Assistance Program
  
  

Compensation: The initial pay range for this position upon commencement of employment is projected to fall between $42.00 and $52.49. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

Position Summary

The Director of Provider Network Management holds a pivotal role in overseeing and optimizing the provider network for our esteemed healthcare organization. This position entails cultivating and nurturing relationships with healthcare providers, orchestrating contract negotiations, and ensuring providers uphold the highest quality and service standards. The Director will play a strategic role in expanding the network, scrutinizing provider performance, and adeptly managing the contracting lifecycle. This role ensures that all healthcare providers meet the necessary qualifications and standards set forth by regulatory bodies, and internal policies.

Requirements

• Strategically lead and manage the provider network while ensuring unwavering adherence to organizational benchmarks and requisites.
• Spearhead the identification and recruitment of new providers to strategically broaden the network's reach.
• Leverage your exemplary negotiation skills to initiate and oversee contract negotiations, while meticulously tracking compliance with contractual obligations.
• Continuously conduct comprehensive assessments of provider performance, encompassing the evaluation of quality metrics and customer satisfaction metrics.
• Collaborate effectively with providers to promptly address concerns, swiftly resolve issues, and ensure seamless solutions.
• Foster and nurture robust relationships with providers, cultivating an atmosphere of collaboration and partnership.
• Devising and executing strategies to elevate network performance and fortify provider engagement.
• Remain vigilant about industry trends and regulatory modifications impacting provider networks.
• Foster harmonious alignment and integration of provider network strategies with other organizational departments.
• Develop, implement, and maintain efficient and effective credentialing processes for onboarding new healthcare providers and renewing existing credentials.
• Review applications, certifications, licenses, education, training, work history, and references to determine eligibility and compliance.
• Coordinate with various departments to gather required documentation for credentialing purposes.
• Stay current with industry regulations, accrediting agency requirements, and licensing standards to ensure continuous compliance.
• Develop and implement policies and procedures to meet regulatory and organizational standards related to credentialing and privileging.
• Provide training and education to staff and healthcare providers regarding credentialing requirements, processes, and best practices.
• Maintain accurate and confidential records of credentialing and privileging activities in accordance with legal and organizational requirements.
• Other duties as assigned.
  
  

Qualifications

• Bachelor's degree in business, healthcare administration, or a related field; advanced degrees are advantageous preferred.
• Possess a minimum of 5 years of demonstrated experience in healthcare provider relations, network management, or comparable domains.
• Extensive comprehension of healthcare provider networking, contracting, and credentialing dynamics.
• Showcase masterful negotiation skills and communicate with exceptional efficacy.
• Exhibit thorough knowledge of healthcare regulatory obligations and accreditation standards.
• Demonstrate adeptness in Microsoft Office suite and proficient database management.
• Boast exceptional interpersonal skills, pivotal for forging and sustaining meaningful relationships.
• Travel when necessary.