Provider Network Specialist II

Job Summary:

The Provider Network Specialist II - Growth is responsible for assisting to expand the provider network in new markets to ensure network adequacy.

Essential Functions:

• Recruit health partners in applicable markets to satisfy network adequacy requirements
• Collect and load contract documents and rosters into Quickbase
• Formats excel rosters according to required standards
• Work with cross-functional teams to ensure that processes developed are standardized and follow established workflows
• Produce detailed reports on key recruitment efforts and provide notification of issues to leadership  
• Manage multiple projects, collect, and analyze data and disseminate to appropriate departments as necessary
• Assist in tracking network adequacy gaps on a weekly basis
• Assist in the loading of providers into the databases, including auditing the loads afterwards
• Track the progress of major projects in order that update reports can be produced for review
• Collaborate with internal resources to ensure projects remain on task for a timely conclusion
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree in Business Administration or related field or equivalent years of relevant work experience is required
• Minimum two (2) years of experience in managed health plan industry is required
• Two to three (2 to 3) years of experience in provider relations / services or related position is required
• Two (2) years or more of project management experience is preferred
• Provider contracting experience is preferred

Competencies, Knowledge and Skills:

• Proficient with Microsoft Office to include Word, Excel and PowerPoint
• Experience with Quickbase is a plus
• Excellent written and verbal communications skills
• Ability to develop, prioritize and accomplish goals
•  Strong interpersonal skills and high level of professionalism
• Effective listening and critical thinking skills
• Effective problem-solving skills with attention to detail
• Ability to work independently and within a team
• Excellent leadership skills
• Ability to create and maintain excellent working relationships

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• May be required to travel occasionally

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a …