Managed Care Specialist - Remote - Full-time/Direct Hire - Healthcare Network Development Expert

Join Our Team as a Managed Care Specialist and Make a Difference in Healthcare

We are seeking a highly skilled and motivated Managed Care Specialist to join our team on a full-time, remote basis. As a key member of our Network Development team, you will play a crucial role in growing our network nationwide by adding new providers that offer Workers Comp services to injured workers. If you have a passion for healthcare, excellent communication skills, and a strong ability to work independently, we want to hear from you!

About Our Company and Culture

Our company is dedicated to providing top-notch healthcare services to those in need. We value our employees and strive to create a work environment that is supportive, collaborative, and inclusive. As a remote employee, you will have the flexibility to work from anywhere while being part of a dynamic team that is committed to making a difference in the lives of others.

Our Mission and Values

Our mission is to provide high-quality healthcare services that exceed our patients' expectations. We value integrity, compassion, and innovation, and we strive to embody these values in everything we do. As a Managed Care Specialist, you will be an integral part of our team and will help us achieve our mission and goals.

Job Summary

The Managed Care Specialist is responsible for growing our network nationwide by adding new providers that offer Workers Comp services to injured workers. This position will be the point of contact to negotiate contract terms that satisfy all internal and external obligations, including State mandates. You will work closely with other Network Specialists, Account Management, and Patient Advocacy teams to ensure seamless communication and collaboration.

Key Responsibilities:

• Research and Recruitment: Research and recruit potential providers for current and new product lines, ensuring that they meet our network requirements and can provide high-quality services to our patients.
• Provider Relationship Management: Build and maintain relationships with potential and existing providers, negotiating contract terms and ensuring that all parties are satisfied.
• Documentation and Tracking: Timely document recruitment status and efforts in our designated tracking system, ensuring that all interactions with providers are accurately recorded.
• Strategic Identification: Identify potential providers based on client needs, ensuring that our network is comprehensive and meets the needs of our patients.
• Telephonic Recruitment: Conduct heavy telephonic recruitment and contact with providers, ensuring that they understand our network and are interested in participating.
• Collaboration and Communication: Work with other Network Specialists, Account Management, and Patient Advocacy teams to ensure seamless communication and collaboration.
• Confidentiality and Security: Strictly adhere to all aspects of our client's Confidentiality, Privacy, and Security Standards Policies and Confidentiality Operating Procedures.

Qualifications and Skills

Essential Qualifications:

• Education: 4-year degree, or equivalent education and experience.
• Experience: Prior experience in a medical (PPO, HMO, Provider Network), insurance, or sales-oriented recruitment environment is required.
• Communication and Negotiation: Excellent communication, negotiation, organizational, and problem-solving skills.
• Documentation and Technical: Proficiency in Microsoft Office skills (Word, Excel, PowerPoint, Outlook).

Preferred Qualifications:

• Experience with Provider Network Development: Experience in provider network development, preferably in the Workers Comp industry.
• Knowledge of Healthcare Regulations: Knowledge of healthcare regulations, including State mandates and confidentiality standards.

What We Offer

Competitive Compensation and Benefits:

We offer a competitive salary and benefits package, including:

• Competitive Salary: A salary that reflects your skills and experience.
• Comprehensive Benefits: A comprehensive benefits package, including medical, dental, and vision coverage.
• Retirement Savings: A retirement savings plan to help you plan for the future.

Career Growth Opportunities:

We are committed to the growth and development of our employees. As a Managed Care Specialist, you will have opportunities to:

• Develop New Skills: Develop new skills and knowledge in the areas of provider network development, negotiation, and communication.
• Advance in Your Career: Advance in your career within our organization, with opportunities for promotion and professional growth.

Work Environment and Culture:

We strive to create a work environment that is supportive, collaborative, and inclusive. As a remote employee, you will have the flexibility to work from anywhere while being part of a dynamic team that is committed to making a difference in the lives of others.

Why Join Our Team?

We are looking for a highly skilled and motivated Managed Care Specialist to join our team. If you have a passion for healthcare, excellent communication skills, and a strong ability to work independently, we want to hear from you! As a Managed Care Specialist, you will have the opportunity to:

• Make a Difference: Make a difference in the lives of patients and providers.
• Grow Your Career: Grow your career in a dynamic and supportive environment.
• Work with a Great Team: Work with a great team that is committed to excellence and making a difference.

How to Apply

If you are a motivated and skilled professional looking for a new challenge, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to [insert contact information]. We look forward to hearing from you!

Apply now and join our team as a Managed Care Specialist!