Provider Partners is searching for a results-oriented individual, with a proven track record, who is passionate about our mission and can generate positive outcomes based on that mission. The Director of Provider Development & Contracting plays a pivotal role in managing and developing relationships with healthcare providers within our network. This position is responsible for ensuring a high level of provider satisfaction and service while optimizing network performance and strategy.
Key Responsibilities:
Provider Relationship Management:
- Serve as the primary contact for healthcare providers.
- Maintain and enhance strong, long-term relationships with providers.
- Address and resolve provider inquiries and concerns in a timely and professional manner.
- Conduct provider orientations and provide ongoing education on PPHP policies, procedures, and new initiatives.
Network Development and Management:
- Identify, recruit, and contract with new providers to expand our network.
- Negotiate contract terms, rates, and agreements with providers.
- Analyze network performance, identify gaps, and recommend improvements.
- Work collaboratively with internal teams to ensure network adequacy and to develop network strategies.
Performance Monitoring and Reporting:
- Monitor provider performance metrics and ensure compliance with contractual and regulatory requirements.
- Prepare and present network performance reports to senior management.
- Evaluate provider satisfaction and recommend strategies for improvement.
Compliance and Regulatory Adherence:
- Ensure provider compliance with state, federal, and PPHP regulations and standards.
- Stay abreast of changing regulatory requirements and ensure timely communication to providers and internal stakeholders.
Project Management:
- Lead and participate in cross-functional projects aimed at improving network performance and provider satisfaction.
Qualifications:
- Bachelor’s degree in healthcare administration, business, or related field required; Master’s degree preferred.
- Minimum of 5-10 years of experience in healthcare network management or provider relations in the state of Indiana.
- Strong knowledge of healthcare industry, contract negotiations, and regulatory compliance.
- Excellent communication and interpersonal skills with the ability to build strong relationships with providers and internal teams.
- Strong analytical and problem-solving skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).