Provider Network Specialist

Overview

The role of Provider Network Specialist is a key role for Your Hearing Network (YHN). This role is essential to ensure the highest quality of provider relationships and provider recruitment to grow the network. The role reports to the Chief Operating Officer (COO) of Birdsong Hearing Benefits, a sister company to Your Hearing Network. The COO also has responsibility for the YHN provider relations and recruitment operations.

 

As a Provider Network Specialist for Your Hearing Network, this strategic role plays a crucial part in ensuring our members have access to high-quality hearing care services. Key functions of this role will include provider relations and provider recruitment. This dual-role position focuses on expanding the network of providers while ensuring that existing providers are well-supported and meet the company's NCQA quality standards. The Provider Network Specialist will identify potential providers, assist in contract negotiations, facilitate the onboarding process, and ensure appropriate growth and retention of the network. Additionally, the role will maintain ongoing relationships with network providers, address any concerns and ensure proper compliance with company policies, NCQA standards, and industry regulations.

 

Key responsibilities include network expansion through strategic recruitment efforts, managing provider relationships, retention, ensuring compliance with credentialing NCQA standards, and collaborating with internal teams to align network development with organizational goals. This role requires strong, crisp communication, experience in negotiation, and relationship management skills, and seasoned experience in the healthcare or hearing care industry.

Responsibilities

ESSENTIAL JOB FUNCTIONS

 

Key Accountability for Provider Relations

Network Management:

• Develop, implement, and manage strategies for expanding and optimizing the hearing care provider network.
• Establish and maintain relationships with hearing care providers, including audiologists, ENT specialists, and hearing aid dispensers.
• Monitor provider performance and service quality to ensure adherence to organizational standards and patient care expectations.

Provider Support:

• Serve as the primary point of contact for network providers, addressing their inquiries and resolving any issues.
• Provide training and support to providers on organizational policies, procedures, and systems.
• Coordinate with providers to ensure timely and effective communication regarding network updates and changes.

Data Management:

• Collect, analyze, and report on data related to network performance, provider metrics, and patient outcomes.
• Utilize data insights to identify trends, areas for improvement, and opportunities for network growth.
• Maintain accurate and up-to-date records of provider information, agreements, and performance evaluations.

Compliance and Quality Assurance:

• Ensure that network providers comply with relevant regulations, accreditation standards, and best practices in hearing care.
• Conduct regular audits and evaluations of provider services and facilities to ensure high-quality care.
• Address any compliance issues promptly and work with providers to implement corrective actions.

Collaboration and Coordination:

• Work closely with internal teams, including clinical, operations, and customer service, to align network strategies with organizational goals.
• Collaborate with internal stakeholders, to enhance network capabilities and patient access to care.

Reporting and Documentation:

• Prepare and present regular reports on network performance, provider metrics, and strategic initiatives to senior management.
• Document network activities, provider interactions, and key performance indicators to support continuous improvement efforts.

 

Key Accountability for Provider Recruitment

Network Recruitment:

• Identify and reach out to potential hearing care providers through various channels (e.g., cold calling, emailing, networking events).
• Present the benefits of joining the hearing network to prospective providers.
• Secure contracts with providers to ensure mutually beneficial terms.

Network Expansion:

• Develop and implement strategies to expand the network in targeted geographic areas.
• Build heat maps, focusing on closing gaps in current network, and driving strong reach into rural areas. State by Sta