Provider Network Director jobs in Schenectady, NY

Provider Network Director directs and develops a healthcare provider network. Designs and administers policies and services that comply with all contractual and regulatory requirements. Being a Provider Network Director requires a bachelor's degree. Typically reports to top management. The Provider Network Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Provider Network Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

Recently Added Provider Network Director jobs

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Director Provider Relations
  • Birdsong Hearing Benefits
  • Santa, MI OTHER

  • Overview

    ABOUT US   Birdsong Hearing Benefits™ LLC, is a hearing benefits manager that views hearing care as total care. We provide Medicare Advantage, including all lines of business in government programs, along with commercial solutions for the most under-utilized supplemental benefit: Hearing.   We are looking for dedicated, talented, and passionate individuals who want to join us in helping people awaken to the full sound of life. We are driven by the following values:   - People focused, realizing it is all about our consumers and each other. - Collaborative with a strong team spirit, happy to work together to achieve greater results. - Intuitive and creative, generating ideas and solutions to transform the hearing care ecosystem. - Full of grit, wanting to work hard to achieve success. - A growth mentality, eager to adapt and be flexible in an ever-changing environment Birdsong Hearing Benefits seeks to hire an Accounts Payable Specialist who will oversee and process transactions within accounts payable to ensure vendors are paid in a timely fashion. In this role, you will work as part of a small, collaborative finance team and collaborate closely with other departments. You will have the opportunity to have a clear impact on the company’s growth while developing your accounting skills. Ideal candidates will thrive in a fast-paced startup environment and grow with the company to take on greater responsibility over time. Summary Your Hearing Network seeks to hire a Director of Provider Relations & Contracting who will be a key member of the executive team. This position actively participates in the oversight of the provider relations and contracting for hearing health care. The Director provides oversight for development of strategies and processes, direction of staff, and execution of all provider relations and contracting tasks within the scope of the operations unit. Key areas of responsibility include provider relations, network management, and contracting services associated with provider contracting negotiations, preparation of contract review with legal and deployment of key contracting elements, and key performance indicators associated with contract guidelines. The mission of the Director, Provider Relations& Contracting is to successfully build, manage, and grow network size and adequacy; network satisfaction; member satisfaction; members being served; member engagement targets; and outcomes targets.

    Responsibilities

    ESSENTIAL JOB FUNCTIONS Key Strategy & Execution - Create solutions and enablement capabilities and align them to the requirements and success criteria of each strategic payer relationship - Working with other executives, rapidly refine the operational plan to ensure overachievement of payer-facing metrics. - Interface with strategic payer clients as the relationship manager and "directly responsible individual" (DRI) to ensure the success of the business and the partnership, including driving clear and aligned goals and execution across both parties. - Responsible to recruit, mentor, and inspire others while holding employees accountable to deliver superior performance - Manage cross-functionally across network operations to ensure organization exceeds expectations including: - Network Operations - Network Contracting and Engagement. Matrixed management of customer success and marketing operations to build, maintain and nurture our networks of customer base to support our payer clients - Network Performance Management. Manage the networks to ensure creation and sustained broad network with strong capability to support payer contracts - Network Performance Management. Manage the networks to communicate, support, and enforce standards and ensure world-class member satisfaction. Network Management - Interfacing directly with provider/other executive sponsors as the executive relationship manager, directly responsible individual (DRI) and program manager to ensure the success of the business and the partnership, including driving clear and aligned goals and execution across both parties - Managing relationships with executive payer/provider/ and key client team members at all required levels in the organization - Owning and driving the agenda - Presenting executive presentations and monthly / quarterly communications to Client executive sponsors including CEO, COO, CFO, CMO, etc. - Looking around the corner to predict client needs, head off issues, and proactively implement plans and actions to mitigate - Achieving / exceeding target program outcomes; manage reporting - Managing cross-functionally internally across network operations to ensure organization exceeds expectations of the strategic programs including: - Network Management and Communication. Manage communications and operational requirements to support strategic partners, all network customers to ensure world-class customer satisfaction. - Contracting: Track and support the delivery of the Network Strategic partner-facing support operations, including metrics reporting, escalation management and experience optimization Key Accountability Metrics - Executes strategic initiatives within given timeframes. - Relationship oversight of all current and potential networks. - Serves as a liaison between network relationships and network partners, Sales, and other operational teams within network. - Provide superior, professional, ongoing, consistent communication and service with designated networks and clients, to maintain a positive, long-term relationships. - Subject matter expert / point person for network related questions and clarifications. - Detailed review, negotiation, editing and sign-off, in coordination with COO and President of Managed Care, of all new and renewing network contracts. - Development, maintenance, and management of a successful provider network. - Manages oversight of analysis and implementation of new and existing networks to validate network need, adequacy, and competitive market rates. - Ensure consistent and thorough review of network legal and compliance updates, in coordination with COO, legal, Compliance Officer and President. - Handle daily network, client, and internal requests, overseeing until resolved. - Proactively resolve network specific issues and needs. - Successful oversight of all network tracking spreadsheets for purposes of maintaining network information, requirements, adequacy, contract changes and pricing. - Manages network projects and initiatives as business needs dictate. - Coordinates network reporting such as, but not limited to, geo access, disruption, and claims analysis reports upon request. - Ensure network is administered within full network guidelines and within the abilities of Key requirements including SLAs. - Oversee elevated network issues to resolution. - Be available for occasional network/client related travel as needed. - Meets annual budget expectations. PROFESSIONAL EXPERIENCE/QuALIFICATIONS Requirements and Must Have Criteria - Leadership and Strategy: We are looking for a leader, first and foremost, who is strategic, inspirational, can drive sustainable change and who can deliver results. The person must have at least 5-7 years of experience with demonstrated success of network management responsibility leading provider relations & contracting efforts for other TPAs, health plans or provider networks. - Proven Track Record Delivering Operational Excellence and Value to Customers: Proven ability to effectively manage end-to-end provider relations & contracting growth and retention is vital. Understanding the voice of the customer is essential to success. The person must be data-driven and analytical in nature. Experience using process-improvement tools such as Lean (Kanban preferred) and Six Sigma is highly preferred. - Deep Healthcare/Health Plan/TPA with Preferred Hearing Aid Domain Expertise: Mission-oriented and energetic, the person must have a demonstrated track record of success in the US healthcare sector with a passion for evidence-based care. The successful candidate needs to possess experience in the healthcare industry with providers, payers, drug, device, and/or diagnostic manufacturers, with supplemental benefit understanding. Seasoned experience in all Lines of Business in managed care. - Staff Management and People Development Skills: Proven and successful track record recruiting, mentoring, and inspiring and empowering individuals with an ability to hold people accountable and to deliver superior performance. Excellent emotional intelligence and ability to identify their own strengths and gaps to maximize impact. Demonstrated ability to delegate effectively and to establish clear guidelines for accountability. - Interpersonal, Communication, and Relational Building Skills: Ability to relate to and effectively work with a diverse group of individuals, groups, and people collaboratively and diplomatically. Proven ability to engage internal and external constituencies. The person must possess an uncanny ability to handle and to resolve conflict in a productive and direct manner. Excellent oral and written communications are a must. The person must also exude high energy with a positive manner and a can-do attitude and excellent judgment. Other Personal Characteristics and Experience - Ability to simultaneously balance and adjust to multiple changing priorities and make decisions with speed and accuracy. - A true team player who takes a collaborative approach with executive peers and other colleagues. Someone who is able and willing to regularly debate constructively, build consensus, and ultimately align around common objectives. A direct communicator who can foster the same among his/her executive level peers. - A strong people leader who is willing and able to apply professional development techniques with direct reports, while always utilizing a cooperative and cross-functional approach. - High level of proficiency and demonstrated effectiveness in problem-solving, and implementing new programs related to increased departmental and organizational operating efficiency. - Successful track record designing, building, and managing complex national enterprise payer relationships lasting a year or more with multiple stakeholders - Ability to move with the speed, agility, and alacrity necessary to create new, foundational capabilities from the ground up - Superb C-suite diplomatic and relationship management skills - Growth mindset – Ability to operate with lean resources and be "hands on" as necessary and "do what it takes" to exceed expectations for your teammates, our customers, and our partners - Systems thinking, with operational and process focus and unrelenting attention-to-detail - Experience building a compliant organization in a complex regulatory environment - Impeccable values, ethical standards, and a strong moral compass with integrity. - Experience in hearing aid industry, as an Audiologist or hearing aid technician would be beneficial but not required. Experience in supplemental benefit design and implementation. - 5 years of managed care experience, including Medicaid, Medicare and commercial insurance payer systems that includes health plan level. Strong negotiation skills required. - Experience overseeing provider relations &contracting functions is required with positive outcomes. - Business savvy and financial acumen.

    Qualifications

    EDUCATION - Business Administration, or related discipline required. A Master Business Management with emphasis on Health Care Administration and/or MBA preferred.
  • 1 Month Ago
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Network Technician
  • EXEControl Global Solutions
  • Halfmoon, NY FULL_TIME
  • Position Overview A Network Technician participates in all functions of the MSP service process. They will cover first- line phone and email support, function as a client liaison, deploy new technolog...
  • 3 Days Ago
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Network Engineer
  • cb20
  • Saratoga Springs, NY FULL_TIME
  • cb20 is a technology solutions provider of choice for organizations that value IT and Managed Services expertise and category-leading customer service. We partner with the world’s leading hardware and...
  • 1 Month Ago
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Network Administrator
  • Brookfield Renewable
  • Queensbury, NY FULL_TIME
  • Network Administrator Work Location: Queensbury, NY Reporting to the Manager, SCADA IT, the Network Administrator will be responsible for ensuring all aspects of Brookfield Renewable IT core infrastru...
  • 1 Month Ago
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Network Engineer II
  • Ellis Medicine
  • Schenectady, NY FULL_TIME
  • Under general supervision manages, implements, maintains, monitors, diagnoses, recommends upgrades, documents, and supports the network systems hardware for Local and Wide Area networks, wireless LAN,...
  • 1 Month Ago
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Senior Network Engineer
  • cb20
  • Saratoga Springs, NY FULL_TIME
  • cb20 is a technology solutions provider of choice for organizations that value IT and Managed Services expertise and category-leading customer service. We partner with the world’s leading hardware and...
  • 1 Month Ago
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0 Provider Network Director jobs found in Schenectady, NY area

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Cybersecurity Network Engineer - Aerospace Research
  • GE Aerospace
  • Schenectady, NY
  • Job Description Summary As a Cybersecurity Network Engineer, you will be an important member of the GE Aerospace Cyberse...
  • 4/19/2024 12:00:00 AM
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Driver (Part-Time)
  • Cox Enterprises, Inc
  • Clifton Park, NY
  • **Primary Location:** PO Box 440 , Clifton Park , NY , US **Driver (Part-Time)** VACCINE POLICY: WHERE PERMITTED BY APPL...
  • 4/19/2024 12:00:00 AM
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HVAC Service Sales Development Rep
  • Johnson Controls International
  • Clifton Park, NY
  • Be part of the future! We are one team, dedicated to working collaboratively to create the purposeful solutions that pro...
  • 4/18/2024 12:00:00 AM
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Technical Director, Utility-Scale
  • New Leaf Energy, Inc.
  • Troy, NY
  • New Leaf Energy is an experienced clean energy developer that partners with landowners, policymakers, and other stakehol...
  • 4/18/2024 12:00:00 AM
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IT Infrastructure Manager
  • NY CREATES
  • Albany, NY
  • About NY CREATES: NY CREATES is a leading research and development hub as well as a commercialization facilitator in adv...
  • 4/17/2024 12:00:00 AM
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Project Manager, Broadband Deployment
  • Empire State
  • Albany, NY
  • Job Description Job Description Applicants must submit a cover letter with their resume to be considered. This position ...
  • 4/16/2024 12:00:00 AM
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Program and Technology Director
  • New York State Community Action Association
  • Guilderland, NY
  • Job Description Job Description Position Overview: The New York State Community Action Association (NYSCAA) is seeking a...
  • 4/16/2024 12:00:00 AM
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Senior Director, Vendor Management
  • MVP Health Care
  • Schenectady, NY
  • Senior Director, Vendor Management Headquarters Office, 625 State Street, Schenectady, New York, United States of Americ...
  • 3/1/2024 12:00:00 AM
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About Schenectady, New York

Schenectady (/skəˈnɛktədi/) is a city in Schenectady County, New York, United States, of which it is the county seat. As of the 2010 census, the city had a population of 66,135. The name "Schenectady" is derived from a Mohawk word, skahnéhtati, meaning "beyond the pines". Schenectady was founded on the south side of the Mohawk River by Dutch colonists in the 17th century, many from the Albany area. They were prohibited from the fur trade by the Albany monopoly, which kept its control after the English takeover in 1664. Residents of the new village developed farms on strip plots along the rive...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Director jobs
$175,580 to $226,836
Schenectady, New York area prices
were up 1.5% from a year ago
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What does a Provider Network Director do?

Provider Network Director in Moline, IL
You can keep costs low when using your plan by staying “in network,” or using the doctors and other health care providers that are in your plan’s network.
December 27, 2019
Provider Network Director in Sacramento, CA
A healthcare provider network is a compilation of all doctors, physicians, hospitals, clinics, pharmacies, etc.
February 22, 2020
Provider Network Director in Springfield, OR
If the plan name includes any of the following things, your plan does NOT use the standard network.
February 12, 2020