Martin’s Point Health Care

Martin’s Point Health Care

Senior Network Representative (remote) - Pittsburg or Cleveland territory

Pennsylvania - Home Office · Senior

Sponsorship not specifiedDetected 27 days ago
SalesExcelResearchLeadershipCommunicationProblem SolvingMentoringPublic SpeakingMicrosoft Office

About the role

  • The Senior Network Representative is responsible for leading the contracting, negotiations, recruitment/expansion, and education functions within their assigned territories.
  • The Senior Network Representative works closely with their leaders and senior leadership to negotiate high-level language and financial contracting terms to secure large contracts.
  • The Senior Representative completes all high-level provider education, including but not limited to new provider orientations, comprehensive, site, and routine trainings.

Requirements

  • Required License(s) and/or Certification(s):

Skills

  • Significant proven advanced knowledge of managed care contracting and reimbursement methodologies
  • Understanding of health plan functions and activities
  • Proficiency in Microsoft Word, Excel, and Access Office Products
  • Superior communication skills, both verbal and written
  • Strong analytical skills to coach employees and providers on benefit and payment polices
  • Strong negotiations skills
  • Ability to make presentations and represent MPHC externally in public forums
  • Strong attention to detail with the ability to organize and execute multiple activities simultaneously
  • Problem-solving skills
  • Ability to work collaboratively to meet goals
  • Ability to work independently
  • Ability to travel with potential overnights at least 50% of the time

Benefits

  • Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond.
  • As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community.
  • This includes, but is not limited to, delivering clinical, financial, and service value to Martin's Point Health Plan Members.

Company info

  • The Senior Network Representative will attend compliance and credentialing site visits to assure we are providing a quality network and meeting HEDIS/NCQA requirements.

Visa & Work Authorization

  • This position is not eligible for immigration sponsorship.

This listing is sourced directly from Martin’s Point Health Care's careers page and normalized into a canonical job model.