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Network Management & Contracting, Professional, BH Provider Relations/Contractin
Schenectady, NY
Job Description
Network Management & Contracting, Professional, BH Provider Relations/Contracting Rep External_B
625 State St, Schenectady, NY 12305, USA Req #1165
Tuesday, July 12, 2022
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
The Professional, External PR represents MVP Healthcare in a professional and ethical manner to underscore its corporate image and mission. Provides service to network providers directly in person or remotely. Provides focused, content laden visits to new and existing physicians and office staff and coordinates resolution of credentialing, claims and contractual issues. Maintains effective, positive, cooperative relationships with network providers with a goal of increasing their overall satisfaction with MVP.
Participates in recruitment of new providers to expand MVP's provider base established and newly licensed/expansion areas through:
Professional, External PR knows, interprets, and follows guidelines of MVP policies and procedures. Maintains and communicates in-depth and up-to-date knowledge of regional competition. Functions as a direct contact for providers with unresolved issues and follows them through to resolution, maintaining detailed documentation. Manages and presents both small and large group presentations independently, including preparing the logistics, agendas, written presentations, content, and evaluations. Actively participates in annual provider seminars and webinars, including preparing the logistics, agendas, verbal presentation, content, and evaluations. Develops and maintains relationships with internal staff including but not limited to regional marketing, claims/operations, member/provider services, Health Management, Quality, Credentialing and Medicare Risk Adjustment team and support them with dissemination of curriculum materials. Acts as a provider liaison for National Network plan and works on complex claim resolution. Assists with Corporate projects as assigned. Performs other duties as assigned.
*This position will be responsible for Medical and Behavioral Health providers / facilities within the western region of NYS.
Minimum Education :
BA/BS Degree in Health, Marketing, or Business Administration preferred or Associates Degree with equivalent combination of experience considered.
Minimum Experience :
2-3 years' experience in a health care field with demonstrated provider recruitment, behavioral health knowledge, and/or service track record preferred.
Requirements:
Excellent communication and interpersonal skills, including the ability to negotiate, interact face-to-face and over the telephone with customers.
Demonstrated strong presentation and facilitation skills.
Behavioral Health & Medical knowledge base.
Demonstrated strong written skills, including the ability to create letters and other communications to providers.
Valid NYS driver's license and access to reliable vehicle, willing to travel extensively throughout MVP's service areas, with overnights as required.
Strong analytical problem solving and strategic business planning skills.
Strong computer skills (Word, Excel and PowerPoint or comparable software) required. Proficiency with Facets, Cactus and Macess within 6 months from date of hire.
Understanding of health insurance reimbursement models.
Able to demonstrate strong relationship building skills.
Fully Vaccinated by date of hire.
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
Apply Now
625 State St, Schenectady, NY 12305, USA Req #1165
Tuesday, July 12, 2022
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
The Professional, External PR represents MVP Healthcare in a professional and ethical manner to underscore its corporate image and mission. Provides service to network providers directly in person or remotely. Provides focused, content laden visits to new and existing physicians and office staff and coordinates resolution of credentialing, claims and contractual issues. Maintains effective, positive, cooperative relationships with network providers with a goal of increasing their overall satisfaction with MVP.
Participates in recruitment of new providers to expand MVP's provider base established and newly licensed/expansion areas through:
- Network analysis to ensure that the MVP network meets all NYS and other requirements regarding network adequacy.
- Identification and solicitation of providers for network recruitment
- Works to remedy deficiencies in network in accordance with State and Federal requirements
- Initiates contract discussions, and works collaboratively with the Leader, Professional Relations in the event of non-standard contract requirements, including contract language and rates, lines of business and product types.
- Conducts sites visits as required by credentialing.
- Meets with providers, facilities, and/or their staff to market, orient, and educate regarding MVP policy protocols, quality and other initiatives.
- Professional, External PR knows, interprets,
Professional, External PR knows, interprets, and follows guidelines of MVP policies and procedures. Maintains and communicates in-depth and up-to-date knowledge of regional competition. Functions as a direct contact for providers with unresolved issues and follows them through to resolution, maintaining detailed documentation. Manages and presents both small and large group presentations independently, including preparing the logistics, agendas, written presentations, content, and evaluations. Actively participates in annual provider seminars and webinars, including preparing the logistics, agendas, verbal presentation, content, and evaluations. Develops and maintains relationships with internal staff including but not limited to regional marketing, claims/operations, member/provider services, Health Management, Quality, Credentialing and Medicare Risk Adjustment team and support them with dissemination of curriculum materials. Acts as a provider liaison for National Network plan and works on complex claim resolution. Assists with Corporate projects as assigned. Performs other duties as assigned.
*This position will be responsible for Medical and Behavioral Health providers / facilities within the western region of NYS.
Minimum Education :
BA/BS Degree in Health, Marketing, or Business Administration preferred or Associates Degree with equivalent combination of experience considered.
Minimum Experience :
2-3 years' experience in a health care field with demonstrated provider recruitment, behavioral health knowledge, and/or service track record preferred.
Requirements:
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
- Job Family Network Management & Development
- Pay Type Salary
Apply Now
- 625 State St, Schenectady, NY 12305, USA
Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
2 to 3 years
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