Provider Relations Specialist-Hospitals (Full-Time Remote, North Carolina Based)

The Provider Relations Specialist is responsible for maintaining a strong and stable provider network by facilitating key recruitment related activities for existing services and maintaining positive, ongoing relationships with health care providing entities.  This position will focus on hospitals, hospital systems, and other facilities to cultivate new provider relationships and provide ongoing provider support.

This is a full-time remote position. The successful candidate must reside in North Carolina and be willing to come onsite for meetings at an Alliance office or travel throughout the communities Alliance serves in NC, as needed.

 Responsibilities & Duties

Recruit Providers to Ensure an Adequate Network of Providers

• Manage assigned recruitment projects and resources 
• Collaborate with Provider Relations team and create strategies for meeting network growth
• Assist in recruiting and retaining qualified and capable hospitals, ancillary groups, facilities, and physicians.
• Plan and execute daily recruitment call schedule and approach            
• Use various network reports, including network adequacy, etc., to identify network gaps in existing assigned networks and recruit hospitals, ancillary groups, facilities, and physicians so networks remain competitive and compliant with state and federal regulations
• Track and report on recruitment interactions and cycle stages using various application tracking mechanisms on a regular basis
• Compile internal data to determine network needs and to increase network

Develop and Maintain Relationships with Hospitals, Ancillary Groups, Facilities, and Physicians

• Maintain professional relationships with hospitals, ancillary groups, facilities, and physicians
• Act as the point of contact for hospitals, ancillary groups, facilities, and physicians
• Provide technical assistance to assigned hospitals, ancillary groups, facilities, and physicians
• Participate on assigned committees and in meetings to provide ongoing feedback using market conditions, industry trends, and provider insights.
• Provide technical assistance and customer service to network hospitals, ancillary groups, facilities, and physicians; other departments; and external stakeholders. This could include researching and troubleshooting issues, collaborating with other departments
• Participate in or facilitate Joint Operating Committee meetings with hospitals/hospital systems or other facilities

Contract Responsibility

• Research, identify, and negotiate contracts as needed within established time lines to support access to services.  This may involve collaboration with legal and finance departments and senior and executive leaders 
• Be knowledgeable of assigned provider contracts with hospitals, ancillary groups, facilities, and physicians  in conjunction with Alliance’s Finance and Contract departments
• Develop and manage scopes of work for hospitals, ancillary groups, facilities, and/or physicians

Collaborate and Communicate

Collaborate and communicate effectively with other Departments and/or with hospitals, ancillary groups, facilities, and physicians to follow-up on any issues and provide outreach or education

Minimum Requirements

Education & Experience

Bachelor’s degree in a Human Services field from an accredited college or university and three (3) years progressive post-degree experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health; 

OR 

Master’s degree in Human Services from an accredited college or university with one (1) years post graduate experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health. 

The following demonstrated skills are preferred:  recruiting healthcare providers; negotiating and managing contracts with hospitals, hospital systems, ancillary groups, facilities, and/or physicians; establishing and maintaining relationships with large and/or complex systems; and providing technical assistance related to contract terms, billing and reimbursement (claims), and managed care.  

Knowledge, Skills, & Abilities

• Knowledge of Alliance’s goals, targets, and outcomes in relation to the responsibilities of the Provider Network Operations department. 
• Knowledge of all disability areas including Mental Health, Substance Use and Developmental/Intellectual Disabilities
• Knowledge and understanding of principles, concepts, and Best Practices used in the treatment, habilitation and support of individuals with needs in any of the disability areas
• Knowledge and understanding of the different system