Healthcare Network Development Executive / 2375

Position Description:

The Network Development Executive is responsible for identifying and evaluating opportunities, negotiating optimal reimbursement rates, and drafting contracts for an assigned provider network to ensure patient access to the highest quality, cost-effective providers of healthcare services in accordance with applicable regulations and MultiPlan policies, practices and procedures.

JOB RESPONSIBILITIES:
1.Negotiate provider contracts to support penetration and discount objectives relative to competitive market tends and client expectations through comprehensive, aggressive execution of region specific contracting goals derived from national and regional objectives related to penetration and discount objectives, and improved contractual terms.
2.Foster and maintain superior provider relationships.
3.May assist in managing relationships with leased networks.
4.Maintain, and preferably exceed, contracting production and quality standards consistent with established regional goals.
5.Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends.
6.Ensure compliance with established policies and procedures, regulatory requirements, and mandatory training requirements (such as but not limited to HIPAA, integrity, product orientation, and contracting tools/resources).
7.Partner with HCE to conduct financial analyses and monitoring of market trends to identify, develop, and implement competitive reimbursement.
8.May serve as mentor to less experienced Provider Contractors through on-going instruction, coaching, modeling, and counseling aimed at developing the type of skills and behaviors that will result in successful resolution of provider contracting. Share provider contracting insights and information with less experienced contractors.
9.Work with Regional Sales and Account Management Peers to respond to and anticipate access requirements and network related performance guarantees. Use information derived from Requests for Proposals (RFP) to assess network adequacy and competitiveness in region.
10.Comply with mandatory training programs requirements, including Human Resources, product orientation and contracting tools and resources.
11.Demonstrate commitment to MultiPlan core values.
12.The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:
The Network Development Executive is considered to be a fully competent professional who knows and applies a broad knowledge of principles, practices, and procedures related to the negotiation and maintenance of provider network contracts. Evaluation, originality, and/or ingenuity are required to complete job responsibilities. Customer interface is primarily face-to-face/in-person. An incumbent works independently and has general latitude and discretion to make commitments with occasional need to confer with their supervisor to obtain guidance on the preferred approach to resolution of situations outside the standardized procedures. The Network Development Executive understands when to escalate a contract issue to the next higher level. An incumbent ensures that decisions consider the full implications (business, legal, and competitive) to both MultiPlan and the customer. While the Network Development Executive does not directly manage others, an incumbent provides mentorship as well as project or work direction to less experienced Provider Contractors who may be assigned to work with them on a project or team basis. The job may require overnight travel to meet with providers in assigned geographical or areas of responsibility.

Qualifications:

"Minimum Bachelors Degree in applicable field, or equivalent experience related to network development
"(required) Minimum of 2 years experience in provider contracting and network development, or equivalent provider/payer experience
"Knowledge and undersanding of provider finance components including budget, charge structure, reimbursement formulas and healthcare finance
"Knowledge of provider organizations and operations applicable to assigned focus
"Communication, business acumen, analytical, negotiation, organization, and prioritization skills
"Ability to understand and apply contract language of MultiPlan and of customer in order to minimize non-standard language changes
"Ability to effectively negotiate rate structures and contract language that is compatible with MPI s business model while limiting risk to MPI and its clients
"Ability to minimize non-standard language by thoroughly understanding our contracts is a must
"Ability to understand relationships and structures of providers and competitors
"Ability to be comfortable with and to manage in-person client interface
"Ability to elicit trust and credibility with all levels of the organization
"Ability to effectively communicate the MultiPlan Value Proposition.
"Ability to work comfortably and routinely as part of a team and to cooperate across organizational boundaries
"Ability to build relationships with internal and external customers
"Ability to persuade
"Ability to use computer software, hardware, and peripherals applicable to role
"Up to 50% tvel within assigned region, primarily to meet with providers on a frequent basis and, at times, with little advance notice, as well as travel to attend MultiPlan sponsored meetings and appropriate professional conferences

Diversity and Equal Employment Opportunity (EEO)
As an Equal Opportunity Employer, MultiPlan will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law.
Country: USA, State: Massachusetts, City: Waltham, Company: Multiplan.