Provider Network Specialist jobs in Brooklyn, NY

Provider Network Specialist coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Provider Network Development Specialist
  • CINQCARE
  • New York, NY FULL_TIME
  •  

    CINQCARE

    NYS Provider Network Development Specialist

    Position Description

     

    Overview

    The Provider Network Development Specialist reports to the Director of Network Management with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don’t have patients or customers – we have Family Members.

     

    The Provider Network Development Specialist initiates, negotiates and executes participating provider agreements for IPA, ACO and other product offerings to expand the provider network’s market footprint as well as CINCARE’s Value Based Payment arrangements in the assigned region. 

     

    This position will communicate contract terms, payment structures and reimbursement rates to providers.  Identifies and recruits providers based on target communities. Advises leadership on the development of functional strategies and matters of business significance. Has familiarity with the assigned region including market intel, provider contacts and existing relationships. Maintains an active pipeline of qualified providers to recruit. Exercises independent judgement and decision making on moderately complex issues regarding job duties, analysis of variable factors and works under minimal supervision.

    Job Responsibilities

    The Provider Network Development Specialist will have the following responsibilities:

    • Develop mutually acceptable set of goals and objectives for provider recruitment in key NY communities by product line offering (e.g. Medicaid, Medicare, ACO REACH, PACE, MAPP/DSNP, MSO)
    • Maintain a comprehensive list of network targets for outreach and leads that will drive success and market penetration. Provide regular updates, respond to inquiries, and address all account concerns in a timely manner
    • Document and memorialize outreach efforts as well as contacts, provide status changes and new developments at team meetings
    • Conduct market analysis and evaluate competitor’s practice and market status
    • Develop strategies to be the preferred provider in  the market vs. the  competition
    • Maintain complete organizational knowledge and product and services familiarity
    • Add value by conveying useful industry, government and practice innovation trends and initiatives
    • Assure Provider satisfaction
    • Meet or exceed individual target goals and departmental objectives

     

    General Duties

    The Provider Network Development Specialist shall have the following duties:

     

    • Leadership: Lead in defining and executing strategies and solutions to create business value in assigned area, including identifying and collaborating with key team members to design, develop, and execute those strategies and solutions to deliver desired outcomes.
    • Strategy: Active participant in establishing the business strategy and roadmap: (1) improve outcomes for family members; (2) enhance the efficacy of other CINQCARE . business divisions; and (3) develop and deliver external market opportunities for CINQCARE products and services. In establishing the business strategy, the Provider Network Development Specialist will be an active participant in defining and contributing to the innovation of sustainable revenue models to drive profitability  for the Company.
    • Collaboration: Ensure that the provider recruitment strategy is aligned with company objectives by working closely with other business divisions to learn their needs, internalize their knowledge, and define solutions to achieve the business objectives of CINQCARE NY
    • Knowledge: Provide subject matter expertise on market landscape and intel, including determining and recommended approaches for provider outreach, engagement, relationship management, information sharing, overcoming roadblocks and closing contractual arrangements.
    • Culture: Is accountable for creating a productive, collaborative, safe and inclusive work environment for the Provider Network  team and as part of the larger Company.

    Qualifications

    The Provider Network Development Specialist should have the following qualifications:

     

    • Education. Bachelor’s degree in business administration or other related field;

     

    • Experience. Minimum of 3-5 years experience in managed care or other health care related network development position(s). Appreciation for details with ability to read and understand provider contracts. Experience with Value Based Contracting;

     

    • Entrepreneurial. CINQ seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring CINQ is positioned to innovatively deliver on its promise by influencing stakeholders and working closely with them to determine acceptable outcomes;

     

    • Communication. Excellent written and verbal communications skills. Experience giving detailed reports and presentations. Competency using computer software to facilitate presentations and reporting. Excellent planning, organizational, and time management skills;

     

    • Relationships. Ability to build and effectively manage relationships with business leaders and external constituents as well as internal stake holders and team members;
    • Culture. Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding and entrepreneurial Company.

     

    Location: The position is based in New York and requires travel to provider offices.

     

    Compensation:  $85k - $110k

  • 24 Days Ago

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Virtual Licensed Clinical Therapist (Remote/Telehealth)
  • Maven Clinic Provider Network
  • New York, NY FULL_TIME
  • Maven is looking for a mission-driven, empathetic full-time Mental Health Provider to support our members through virtual care services. As a full-time virtual provider, you will have the opportunity ...
  • Just Posted

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Reproductive Endocrinologist
  • Maven Clinic 1099 Provider Network
  • New York, NY FULL_TIME
  • Maven is looking for a mission-driven, empathetic reproductive endocrinologist to support our members through virtual care services. As a virtual provider, you will have the opportunity to meet with m...
  • 27 Days Ago

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Authorization Specialist
  • NorthEast Provider Solutions Inc.
  • Valhalla, NY FULL_TIME
  • Job Details: Job Summary: The Authorization Specialist is responsible for performing complex clerical procedures related to verifying insurance information and obtaining authorization for hospital pro...
  • 20 Days Ago

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Charge capture specialist
  • NorthEast Provider Solutions Inc.
  • Hawthorne, NY FULL_TIME
  • Job Details : Job Summary : Job Summary : The Charge Capture Specialist is responsible for ensuring that all billing charges are captured in an appropriate manner. Identifies, analyzes and reconciles ...
  • 26 Days Ago

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Provider Network Performance Coordinator
  • Centers Plan for Healthy Living/Centers Care Solutions
  • New York, NY FULL_TIME
  • JOB SUMMARY: The Provider Network Performance Coordinator is responsible for the oversight of the performance and quality of the CPHL provider network. PRIMARY RESPONSIBILITIES: Independently conducts...
  • 13 Days Ago

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0 Provider Network Specialist jobs found in Brooklyn, NY area

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Network Engineer
  • NR Consulting
  • Middletown, NJ
  • Role: Network Engineer Type: Contract Location: Middle town, NJ (Onsite) Duration: Long Term Description: Multivendor ex...
  • 3/27/2024 12:00:00 AM

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Network Engineer
  • Mindteck
  • New York, NY
  • Network Engineer: should be taking care of both Azure and on-prem network management, Strong experience in Azure Managed...
  • 3/26/2024 12:00:00 AM

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Network Engineer
  • PGM TEK, Inc.
  • New York, NY
  • Job Description We are looking for a Senior IT Network Engineer for a long term consulting assignment with a global fina...
  • 3/26/2024 12:00:00 AM

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Network Engineer
  • Diverse Lynx
  • New York, NY
  • Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration fo...
  • 3/26/2024 12:00:00 AM

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Network Engineer
  • Chobani
  • New York, NY
  • Summary Responsible for analyzing, designing, installing, configuring, maintaining and repairing of global network infra...
  • 3/26/2024 12:00:00 AM

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Network Engineer
  • Infosys
  • Mahwah, NJ
  • Job Description: Infosys is seeking a Network Engineer with strong interpersonal and technical skills to operate a large...
  • 3/26/2024 12:00:00 AM

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Network Engineer
  • RightTalents LLC
  • New York, NY
  • The ideal candidate will be responsible for maintaining and intermittently improving our current network configuration a...
  • 3/25/2024 12:00:00 AM

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Network Engineer
  • Crescens, Inc.
  • New York, NY
  • Job Title: Network Engineer Location: 2MTC NYC Duration: 12 Months Note: Normal business hours Monday-Friday 35 hours/we...
  • 3/25/2024 12:00:00 AM

Brooklyn totals 97 square miles (250 km2) in area, of which 71 square miles (180 km2) is land (73%), and 26 square miles (67 km2) is water (27%); the borough is the second-largest in land area among the boroughs of New York City. However, Kings County, coterminous with Brooklyn, is New York State's fourth-smallest county by land area and third-smallest by total area. Brooklyn lies at the southwestern end of Long Island, and the borough's western border constitutes the island's western tip. Brooklyn's water borders are extensive and varied, including Jamaica Bay; the Atlantic Ocean; The Narrows...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$69,112 to $103,354
Brooklyn, New York area prices
were up 1.6% from a year ago

Provider Network Specialist in Springfield, MO
As the liaison between provider and the health plan, candidates are tasked with ensuring improved revenue generated and patient quality score.
December 16, 2019
Provider Network Specialist in Stamford, CT
Previous experience in a network development, provider recruitment or provider contracting.
December 04, 2019
Provider Network Specialist in Fort Wayne, IN
In this position, employees will be expected to perform benefits analysis and create reports on provider performance to support the needs of the analysis found.
January 18, 2020