Network Development Associate
Job Details
Undisclosed
417 Washington Street - Columbus, IN
Full Time
Undisclosed
Undisclosed
Undisclosed
Day Shift
Undisclosed
Description

Job Title:         Network Development Associate

Reports To:     Vice President – Health System Development               

 

This is an exempt position which has two primary responsibilities: Network contracting and serving as the relationship manager for our PPO rental networks. Both roles require research and prioritization of network needs, market opportunities, and strategical approaches to hospitals and providers that strengthens SIHO’s market position. The position requires disciplined and thorough analysis, financial analysis and modeling, and proficient writing and verbal communication skills. Assisting our Sales, Account Management, Reinsurance, and Finance teams in understanding and quantifying our network strengths and weaknesses is important to the growth and profitability of our organization.

 

Brief Description of Duties:    

  • Develop planning structure (goals/objectives and timelines) to expand SIHO contracting in assigned territory, for example a narrow network around a strategic hospital partner.
  • Analyze networks for potential business relationships to support SIHO clients where the SIHO Network is inadequate or not available.
  • Develop and negotiate contractual agreements with new health care providers and institutions within state and federal regulatory guidelines.
  • Prepare, execute and maintain provider contracts, including renegotiation with current SIHO Network providers.
  • Function as the point-of-contact for all on-going contractual issues as needed by providers
  • Negotiate Single Case Agreements (SCA) with non-participating providers as requested by Medical Management and Account Management.
  • Function as the Provider Network expert for the organization, able to analyze and recommend the optimal network solution for current and prospective customers.
  • Coordinate with PPO Networks, Data Management, Reinsurance, and Finance to ensure our networks competitiveness is appropriately reflected in our pricing.
  • Work closely with and provide support to Health Systems Development, Sales and Account Management to provide network support for new business development initiatives.
  • Work with and provide support to Provider Services Specialists on contractual issues and to assure smooth and efficient operations.
Qualifications

Minimum Skills Requirement:

 

  • B.S. Degree or equivalent work experience in a managed care organization.
  • Ability to communicate clearly in oral and written presentations.
  • General knowledge and understanding of the health care industry.
  • Demonstrated ability as a problem solver.  (i.e., use of analytic and logic skills)
  • Demonstrated success in use of negotiating skills.
  • Knowledge of provider reimbursement methodologies including Medicare, Case Rates, Bundled Payments, Value Based Care models.
  • Maintain confidentiality in all levels of internal and external communications.
  • Ability to work independently or as a member of the network services team.
  • Professional appearance and presence.
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