Provider Network Director jobs in Charleston, WV

Provider Network Director directs and develops a healthcare provider network. Designs and administers policies and services that comply with all contractual and regulatory requirements. Being a Provider Network Director requires a bachelor's degree. Typically reports to top management. The Provider Network Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Provider Network Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Director of Network Development, Home Health Care
  • Stonerise Corporate
  • Charleston, WV FULL_TIME
  • Director of Network Development, Home Care

    The CommuniCare Family of Companies currently owns/manages 100 World-Class Healthcare Centers throughout Ohio, Indiana, Missouri, Pennsylvania, Virginia, West Virginia, and Maryland. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living communities.

    CommuniCare is currently recruiting for a Director of Network Development for our Home Care division based in West Virginia.

    PURPOSE/BELIEF STATEMENT:

    The Director of Network Development plays an intricate part in the Executive Leadership Team and leads the Home Care network in improving the patient access experience through provider engagement and referral management. This includes an emphasis on management of Stonerise Home Care payor relations and the patient referral and intake process. This Director of Network Development reports directly to the VP of Operations and will strengthen collaborative relationships across the Home Care and Hospice organization. This candidate must have experience working with Home Health in the Operations capacity and/or the Payor capacity.

    WHAT WE OFFER:

    As a CommuniCare employee you will enjoy a great team environment, competitive salary, PTO plans, and our outstanding, robust benefits package. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

    QUALIFICATIONS AND EXPERIENCE REQUIREMENTS:

    • Requires a Bachelor’s Degree in business, healthcare administration, finance, or a relevant field of study.
    • 5 years of managed care provider relations, provider contracting, or provider data management experience; Medicare Advantage experience preferred.
    • Home Health expansion experience a plus
    • Must have experience working with Home Health through Operations or Payor capacity

    KNOWLEDGE/SKILLS/ABILITIES

    • Must have integrity and a strong ethical compass.
    • Must be entrepreneurial, flexible, creative, and naturally curious.
    • Must be excited by the opportunity to work within an integrated delivery system.
    • Must have a vision, be highly organized, and self-directed.
    • Must have strong communication skills and the ability to work effectively with people coming from diverse cultural and professional backgrounds.
    • Must haves strong analytic and financial reasoning skills.

    JOB DUTIES/RESPONSIBILITIES

    • Management of Provider and Vendor network performances, including strategies for adequacy and effectiveness
    • Payor Relationships that facilitate contracting and payment.
    • Admission and Census targets
    • Oversight of Home Health and Hospice Patient Intake
    • Reputation of the Home Care and Hospice organization
    • Develops and implements strategies in collaboration with Compliance to ensure all state and federal regulatory requirements within the scope and span of control for the department are in the collaboration and best interests of the Home Care and Hospice departments. This includes, but is not limited to:
    • Accuracy, timeliness, and adequacy with patient records
    • Soundness of provider contracting strategy and approach
    • Supports adequateness and effectiveness while providing elements of incentive or value-based purchasing arrangements
    • Adheres to and participates in Compliance, Quality assurance, all while directing communication to other key divisions across the Home Health and Hospice enterprise
    • Amending provider agreements to meet statutory, regulatory, or business needs of the Home Health and Hospice enterprise

    About Us

    A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.

  • 9 Days Ago

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Peer Support Specialist
  • Positive Recovery Solutions - Mobile Vivitrol Provider
  • Charleston, WV PART_TIME
  • We are looking for a Patient Support Staff to assist our patients at their doctors appointment. Because we are a mobile clinic, employees must have their own reliable transportation and a valid driver...
  • 1 Day Ago

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Instructor, CTT Network Cable
  • Management & Training Corporation
  • Charleston, WV FULL_TIME
  • OverviewPay: $42,993.60 annuallyWork with a purpose! Begin a career as part of our team, utilizing your skills and abilities to change the life of a Job Corps student. Position name: Instructor, CTT N...
  • 1 Month Ago

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CISCO Network Engineer
  • A.C. Coy
  • Charleston, WV OTHER
  • Overview Tier One is seeking a Network Engineer that can provide hands-on network services in routing, switching, and network design; and provide general support in the areas of Wireless Networking, N...
  • 1 Month Ago

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Prep Girls Hoops Scout (West Virginia)
  • Prep Network
  • Charleston, WV PART_TIME
  • About Prep NetworkPrep Network (www.prepnetwork.com) operates websites -- 100 in total -- aimed at maximizing visibility and value for high school athletes at all levels. Our scouts provide content, p...
  • 15 Days Ago

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Hearing Care Provider
  • Demant
  • Summersville, WV OTHER
  • Overview HearingLife is part of Demant, a world-leading hearing healthcare group built on a heritage of care and innovation since 1904. HearingLife operates more than 600 hearing care centers across 4...
  • 21 Days Ago

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0 Provider Network Director jobs found in Charleston, WV area

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Director of Sales
  • Service Wire Company
  • Culloden, WV
  • Location: Culloden, WV (On-Site when not traveling on business) Reports To: Vice President of Sales and Marketing As the...
  • 3/28/2024 12:00:00 AM

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Information Technology Manager -- IS Clinical Foundations -- Northgate-400 Association Dr.
  • CAMC Health System
  • Charleston, WV
  • Job Summary Provides leadership and management of the day-to-day operations of areas that include Network Infrastructure...
  • 3/28/2024 12:00:00 AM

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Director of Quality and Risk
  • Encompass Health
  • Huntington, WV
  • The Quality/Risk Director is responsible for an environment and culture that enables the hospital to fulfill its mission...
  • 3/28/2024 12:00:00 AM

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Sales Director - Location: Ripley, WV
  • Anytime Fitness
  • Ripley, WV
  • Please upload a full resume! Share our passion for helping people and help fuel our amazing growth! Anytime Fitness is s...
  • 3/27/2024 12:00:00 AM

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Technical Director
  • Precision Castparts
  • Huntington, WV
  • Country 1 United States of America State / County 1 West Virginia City 1 Huntington Division 1 Energy Company 1 HBE Func...
  • 3/27/2024 12:00:00 AM

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Restaurant Manager
  • Gecko Hospitality
  • Nitro, WV
  • Job Description Restaurant Manager MONTHLY BONUS that actually pays out each month!! We are in search of a Restaurant Ma...
  • 3/26/2024 12:00:00 AM

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Regional Sales Director - Enterprise
  • Segra
  • Charleston, WV
  • Segra is searching for a dynamic and experienced Regional Sales Director to lead a sales team based in the Charleston WV...
  • 3/25/2024 12:00:00 AM

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Senior Country Clinical Quality Management Lead (Remote)
  • Careerbuilder
  • Charleston, WV
  • Merck Senior Country Clinical Quality Management Lead (Remote) Charleston , West Virginia Apply Now It is critical that,...
  • 3/25/2024 12:00:00 AM

Charleston is the most populous city in, and the capital of, the U.S. state of West Virginia. Located at the confluence of the Elk and Kanawha rivers, the population during the 2017 Census Estimate was 47,929. The Charleston metropolitan area as a whole had 214,406 residents. Charleston is the center of government, commerce, and industry for Kanawha County, of which it is the county seat. Early industries important to Charleston included salt and the first natural gas well. Later, coal became central to economic prosperity in the city and the surrounding area. Today, trade, utilities, governm...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$157,663 to $203,693
Charleston, West Virginia area prices
were up 1.2% from a year ago

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You can keep costs low when using your plan by staying “in network,” or using the doctors and other health care providers that are in your plan’s network.
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A healthcare provider network is a compilation of all doctors, physicians, hospitals, clinics, pharmacies, etc.
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If the plan name includes any of the following things, your plan does NOT use the standard network.
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