Top Provider Network Executive plans and directs all aspects of an organization's provider network function. Responsible for developing the network and negotiating and administering contracts. Being a Top Provider Network Executive oversees provider relations and monitors and directs all provider services. Requires a bachelor's degree. Additionally, Top Provider Network Executive typically reports to a top management. The Top Provider Network Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Provider Network Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
POSITION SUMMARY:
Develops, implements, and monitors the person-centered Total Plan of Care (TPOC) for assigned members with behavioral health needs, developmental/intellectual disabilities, and/or substance use disorders, and other special populations; works closely with members, their families/guardians, their providers, and other members of their circle of support, to ensure the member is receiving the most appropriate care while addressing barriers to access to healthcare.
ESSENTIAL JOB FUNCTIONS:
2. Ensures that members’ health, safety, and service needs are met by working directly with the individual members, their families/guardians, their providers, and other members of their circle of support.
SECONDARY DUTIES AND RESPONSIBILITIES:
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