sheboygan | Provider Relations & Network Specialist in Milwaukee, WI

Provider Relations & Network Specialist

  • MY CHOICE FAMILY CARE
  • 1309 N 71st St
  • Milwaukee, WI 53213
  • Full-Time
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Position Title: Provider Relations & Network Specialist

Reports To: Provider Relations Manager

Position Type: Full-Time

Location/ Office: Wauwatosa

Start Date: Immediately

Organization Overview

Position Summary

* Anticipate ongoing network needs by analyzing demographic trends, community priorities, capacity, and utilization data.
* Plan strategies for recruitment, selection, and retention of qualified Network Providers.
* Develop, contract, maintain and enhance relationships with providers.
* Develop policies and procedures to oversee contract performance and compliance.
* Design innovative service delivery methods to improve quality service and ensure cost-effectiveness.
* Analyze price proposals, service delivery proposals, financial data and other information to determine reasonableness and cost-effectiveness of Provider service.
* Negotiate and award contracts.
* Analyze price proposals, service delivery proposals, financial data and other information to determine reasonableness and cost-effectiveness of assigned provider service categories.
* Negotiate, develop and design cost-effective contracts including language and pricing methodologies.
* Problem solve network issues related to assigned provider service categories with Contracts Manager.
* Ensure policies and procedures to oversee contract performance and compliance are operating as required.

Position Requirements

* Experience drafting, reviewing and analyzing contractual documents.
* Ability to research and review laws, statutes, ordinances, and procedures relative to Provider Network service areas.
* Knowledge of and experience implementing network development, retention and management strategies.
* Ability to review and analyze trends, priorities and needs to ensure adequate Provider Network capacity
* Strong negotiation skills, able to negotiate provider contract and price agreements, for diverse services areas.
* Ability to listen, formulate and implement problem resolution strategies and recommendations.
* Strong interpersonal and communication skills, which must include the ability to work effectively with a wide range of constituencies in a diverse community.
* Ability to formulate and implement strategies to measure provider quality, including service quality, relative to contract specifications and program requirements.
* Access to a reliable vehicle
* Automobile insurance coverage (at time of application and throughout employment)



* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.