Provider Network Service Development Specialist (Full-Time Remote, North Carolina Based)

The Provider Network Service Development Specialist supports the development and management of the Provider Network, including assisting with the development of services, and recruiting providers to fulfill network needs. This position will also assist in the coordination of cross-departmental initiatives, identified internally or by the State of NC and assist in the oversight of Provider Network activities related to special initiatives, with a focus on new service implementation.

This position is full-time remote; however, may require some occasional travel within the communities Alliance serves. The selected candidate must reside in the state of North Carolina.

Responsibilities & Duties

Identify New Services

• Identify and recommend new services and supports to address gaps in the service array
• Research new services identified
• Assist in recruiting and retaining qualified and capable providers to provide new services
• Analyze funding incentives and disincentives for best practices

Oversee activities related to New Service Implementation

• Review and approve the addition of new services to existing providers.
• Develop Scopes of Work (SOW) and lead the process to finalize the SOW and gain approval.
• Ensure all programs, services, and systems are developed in accordance with Local, State and Federal Performance Standards, and congruent with Alliance organizational and procedure manuals
• Assist in the identification and coordination of internal and external training needs as it relates to new service development
• Develop and lead new Provider Collaboratives related to new service or pilot project implementation

Provide technical assistance and customer service to network providers

• Ensure that Evidence Based and Best Practice services for consumers are in place as identified and are available for consumers
• Assist, guide and support providers in the development and maintenance of comprehensive, outcome focused consumer service
• Be knowledgeable of assigned provider contracts with agencies and organizations in conjunction with Alliance’s Finance and Contract departments
• Provide technical assistance and feedback for the use of local and state funds, new service delivery and adherence to best practice standards and contractual requirements

Internal and External collaboration

• Arrange and facilitate interdepartmental, provider and State personnel workgroups
• Represent Alliance on State Committees, as applicable
• Assist in the coordination of cross-departmental Initiatives as identified
• Establish and maintain relationships and collaborations with relevant public, private, and provider agencies, in order to assure open communications, avoid misunderstanding and support solution focused atmosphere within the community
• Participate in the creation of and attend and or lead newly created Provider Learning Collaboratives

Out Of Network (OON) Review

• Evaluate Out of Network requests based on Network capacity and approve or deny requests

Collaborate with internal departments to develop solutions to identified needs

• Partner with Claims, Business Operations, Medical Management, and other areas to address ongoing needs and develop solutions

Minimum Requirements

Education & Experience

Bachelor’s degree in a Human Services field from an accredited college or university and five (5) 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 three (3) years post graduate experience in the field of Mental Health, Substance Use, Intellectual/Developmental Disabilities or Physical Health. Preferred Qualifications: Previous Provider Network experience. Licensure and/or certification in area served preferred

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 systems that impact Providers
• Microsoft Office suite, including Excel
• Proficient with database maintenance
• Exceptional interpersonal skills
• Highly effective Communication