Provider Network Specialist jobs in Pompano Beach, FL

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth, improve outcomes, reduce costs, and bring value to their members.

Through our comprehensive suite of innovative supplemental benefits, fintech payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the social determinants of health and improve member health outcomes and satisfaction.

Our compliance-focused infrastructure, proprietary technology systems, and premier service delivery model allow our health plan partners to deliver high-quality, value-based care to millions of members.

We offer a fulfilling work environment that attracts top talent and encourages all associates to contribute to delivering premier service to internal and external customers alike. Our goal is to transform the healthcare industry for the better! We provide career advancement opportunities from within the organization across multiple locations in the US, South America, and India.

Role

This position identifies, contracts, and maintains relationships with participating providers within assigned geographic territory. This position is responsible for appropriately representing providers relating to contractual requirements, reimbursement, compliance, credentialing, and provider registration policy and procedures. Work closely with key internal functional teams to ensure successful implementation of provider agreements from initiation to approval. This position requires excellent interpersonal skills to communicate effectively.

Primary Responsibilities

• Develop and implement recruitment plans to attract high-quality hearing healthcare providers to join the NationsHearing network.
• Complete outbound calls to potential providers to invite them to participate in the NationsHearing Provider Network
• Monitor the contracting process to ensure contract administration objectives are achieved and the provider data registration process is completed successfully.
• Assist with the network development strategies to support patient access & availability and membership growth of health plan partners.
• Analyze network adequacy and regularly assess the existing provider network to ensure access to care for contracted health plan members.
• Identify gaps in coverage and create contracting strategies to recruit providers to fill gaps effectively.
• Utilize multiple strategies to identify potential providers, perform outreach, and present the benefits of the NationsHearing program.
• Cultivate and maintain relationships with manufacturers and strategic partners to promote our network and establish partnerships.
• Negotiate with potential providers on contract terms, fee schedules, and service agreements that align with the program’s operational goals.
• Act as ongoing liaison to providers throughout the contracting process.
• Coordinate with the Data Management Specialist to reconcile data gaps between our system and agreements, registration, and applications.
• Maintain lead records with status details and outreach communication efforts.
• Other duties as required.

Qualifications

• Bachelor’s Degree
• Provider Network Development
• Creative mindset
• Basic to intermediate knowledge of Microsoft Applications
• Quick learner and self-motivated
• Ability to work as a team member or independently
• Calm under pressure
• Strong problem-solving skills
• Professional presentation and demeanor
• Availability to work after regular business hours, including weekends and holidays, when needed.

NationsBenefits is an Equal Opportunity Employer