Provider Network Specialist jobs in West Palm Beach, FL

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 Developer
  • Medi-Trans Inc
  • Deerfield, FL FULL_TIME
  • About Us

    MTI America is a health solutions company located in sunny Fort Lauderdale. As a leader in the Worker's compensation industry, our team of dedicated professionals seamlessly coordinates and delivers our ancillary product and service offerings. Passion for people is at the core of everything we do, and we understand the impact of empathy in healthcare. As a company built on lasting relationships, we utilize our network of providers to consistently deliver compelling customer-centric solutions from transport to language and medical services. Nationwide!

    The MTI family has a strong passion for efficiency, customer care, and our people. We love what we do, we strive to be the best, and we are thrilled to serve our customers. We strongly believe that our culturally diverse teams of overly ambitious people are what makes our company a great place to work. We value our employees as much as we do our customers and offer a supportive environment complete with competitive compensation, benefits, and growth opportunities.

    At MTI America, you will have a significant impact on the quality of care our patients receive. Your service will directly impact injured workers and their quality of life.


    Summary

    The Provider Network Developer initiates and closes on sales for the network expansion in defined territories and works as the liaison between Providers and organization. Identifies, selects, drafts, negotiates and sells final contracts. Creates processes and procedures to ensure overall quality of provider services. Facilitates development of relationships with providers, maintains relationships for long-term contracts, and mediates performance and scorecard disputes.

     

    Job Responsibilities

    • Creates short and long-term contracting sales strategy for the development and improvement of MTI America’s provider network.
    • Negotiates all new and existing contracts within assigned territory.
    • Ensures contractual agreements are met.
    • Develops alternatives, strategies and plans of action to facilitate the negotiation process.
    • Works independently and as part of a team on contract negotiations, re-negotiations, contract preparation, provider relations and recruitment.
    • Reduces cost of goods sold through contract negotiations and re-negotiations of existing vendor contracts.
    • Ensures quality components of service delivery and patient/carrier satisfaction with services provided.
    • Establishes relationships with providers and prepares hand-off to account management team.
    • Participates in process for continuous credentialing and quality monitoring of assigned accounts.
    • Monitors state fee schedules to ensure vendor compliance.
    • Works with team to identify margin opportunities by performing analysis out of network utilization and using data to identify network development opportunities.
    • Performs ad-hoc negotiations with out of network vendors and strategically recruits new vendors based on feedback from Operations and Sales.
    • Works closely with Internal Audit and Compliance (IAC) department to ensure vendor compliance with contracts as well as MTI America’s billing and other protocols.
    • Identifies potential vendors for recruitment into the MTI America’s Management network
    • Identifies white space and targets vendors in those areas for inclusion in the MTI America’s Management network.
    • Manages contract process including distributing and receiving contracts.
    • Acquires credentialing applications at initial contracting.
    • Acquires liability and licensure on each provider at initial contracting.
    • Other duties as assigned.


    Skills and Expertise

    • Good understanding focused on Transportation and language service industry and ancillary products and services.
    • 3 years’ experience in network development in healthcare required; workers’ compensation preferred.
    • Knowledgeable of contract negotiation principles.
    • Excellent verbal and written communication skills to technical and non-technical audiences of various levels in the organization (e.g. executive, management, individual contributors).
    • Excellent problem solving, team and time management skills managing multiple deadlines for self and others.
    • Proficiency to operate independently on work that is often confidential in nature.
    • Proficient in Microsoft Office Suite required.

     

    Education Requirements

    • High School Diploma or equivalent required. College degree preferred.

     

    Travel Requirements

    • N/A

     

    Physical Demands/Work environment

    • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    • Individuals may need to sit or stand as needed. May require walking primarily on a level surface for periodic periods throughout the day. Reaching above shoulder heights, below the waist or lifting as required to file documents or store materials throughout the workday. Proper lifting techniques required. On occasion, may include lifting of up to 5 pounds for files and computer printouts.
    • For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands, and fingers speak, and hear.
    • Hearing, vision, and talking. Specific vision abilities required by this job include ability see things from a close distance and ability to adjust focus.
    • Utilizes fluorescent lighting; noise level is moderate. For the most part ambient room temperatures, lighting and traditional office equipment as found in a typical office.

     

     

     


  • 8 Days Ago

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Manager Provider Network Management
  • AmeriHealth Caritas Health Plan
  • Palm Beach Gardens, FL FULL_TIME
  • Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. A...
  • 1 Month Ago

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Provider Network Account Executive I
  • AmeriHealth Caritas Health Plan
  • Palm Beach Gardens, FL FULL_TIME
  • Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities....
  • Just Posted

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Telephone/Network Support Specialist
  • Martin County School District
  • Stuart, FL FULL_TIME
  • Click here for full job description:http://www.martinschools.org/files/_hKBpN_/743ef449522dcb5c3745a49013852ec4/Telephone_Network_Support_Specialist.pdf
  • 23 Days Ago

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Provider Support Specialist
  • Cano Health
  • Jupiter, FL FULL_TIME
  • Provider Support SpecialistCano Health is a rapidly growing operator of healthcare centers specializing in Senior Care and Primary Care for all ages. We are a vibrant company culture founded on the pi...
  • 17 Days Ago

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Medical Front Desk Receptionist
  • ENT Specialist
  • Boynton, FL FULL_TIME
  • Are you a friendly and organized individual looking for an exciting new opportunity in the healthcare industry? If so, we are looking for a Medical Front Desk professional to join our growing Otolaryn...
  • 15 Days Ago

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0 Provider Network Specialist jobs found in West Palm Beach, FL area

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Sr. Network Engineer
  • Kolter Solutions
  • Fort Lauderdale, FL
  • Kolter Solutions is seeking a Senior Network Engineer Location: Remote Job Description: This client-facing role offers a...
  • 3/28/2024 12:00:00 AM

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Network Engineer / Computer Support Technician
  • Applications by Design Inc
  • Boca Raton, FL
  • Job Description Job Description Seeking qualified Computer Support and Network Technician to join our team! A successful...
  • 3/28/2024 12:00:00 AM

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Project Site Supervisor - Electronic Security Systems (ESS)
  • KBR
  • Jupiter, FL
  • Title: Project Site Supervisor - Electronic Security Systems (ESS) KBR is seeking a Project Site Supervisor to join our ...
  • 3/28/2024 12:00:00 AM

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Network & Cabling Technician - Sporting Events
  • Safari Solutions Strategic Technology Partners
  • Palm Beach Gardens, FL
  • Job Description Job Description Safari Solutions has an immediate need for a full time Network & Cabling Technician to j...
  • 3/27/2024 12:00:00 AM

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Network Technician & System Administrator (T2) for MSP
  • Caperion Computing
  • Delray Beach, FL
  • This position is available immediately offering competitive pay based on skill level and experience. We are an establish...
  • 3/26/2024 12:00:00 AM

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Network Engineer
  • ASR Group/Domino Sugar
  • West Palm Beach, FL
  • Florida Crystals is a leading domestic sugar producer and North Americas first fully integrated cane sugar company, guid...
  • 3/25/2024 12:00:00 AM

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Senior Manager Advance Networking
  • Hotwire Communications Ltd
  • Fort Lauderdale, FL
  • RESPONSIBILITIES Design, deploy and maintain Hotwire's EGP, IGP, MPLS, IPv6, CGNAT, and PIM strategies Identify, researc...
  • 3/25/2024 12:00:00 AM

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Network Engineer Senior
  • Jupiter Medical Center
  • Jupiter, FL
  • Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-clas...
  • 3/24/2024 12:00:00 AM

West Palm Beach is a city in and the county seat of Palm Beach County, Florida, United States. It is located immediately to the west of the adjacent Palm Beach, which is situated on a barrier island across the Lake Worth Lagoon. The population was 99,919 at the 2010 census. West Palm Beach is a principal city of the Miami metropolitan area, which was home to an estimated 6,158,824 people in 2017. It is the oldest incorporated municipality in Greater Miami, having been incorporated as a city two years before Miami in November 1894. West Palm Beach is located approximately 68 miles (109 km) nort...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$57,370 to $85,794
West Palm Beach, Florida area prices
were up 1.5% 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