Value Based Network Specialist

DescriptionSanitas is a global healthcare organization expanding across United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness.Position SummaryDevelop and implement a strategic plan to build a preferred provider network, through strategic relations with clinicians, government agencies, hospital networks and external stakeholders. Set metric system to ensure proper provider engagement, and alignment with company’s value-based vision.

 

Essential Job Functions:

As a Network Specialist in Healthcare Services, you will be responsible for a wide range of activities to optimize the provider network's performance and quality while fostering growth and collaboration within the organization. You will work closely with various teams to achieve these objectives.

Key Responsibilities:

Regional Network Management and Development: Build, refine, and manage a tiered network of preferred external specialists and facilities to form a robust Provider Network. Identify ways to diversify the network to meet client needs, enhance quality, and reduce service costs.

Operational Performance Monitoring: Monitor operational performance and ensure contractual compliance. Perform in-depth market analyses to identify current and future healthcare needs and assess the performance of the provider network.

Quality and Efficiency Improvement: Collaborate with cross-functional teams to address enterprise and regional issues, aiming to enhance quality measures, clinical outcomes, financial performance, and operational efficiency. Implement workflow design and redesign initiatives, including optimization of electronic health records and performance reporting.

 

Relationship Management: Establish and maintain positive relationships with office staff, physicians, and internal departments. Foster strong collaboration and communication to ensure seamless operations and optimal patient care.

Provider Communication: Ensure communication and resolution of provider issues, working closely with applicable team members and other departments. Support communication and collaboration with health plans at a market level, including coordinating joint operating committees.

Training and Best Practices: Provide training and guidance to market staff on network and referral strategies. Share best practices and identify potential innovations with senior leadership to drive continuous improvement.

Market Growth Support: Partner with Senior Management and other departments to develop a comprehensive network strategy that supports market growth in Health Plans and Insurance Services. Contribute to the success of market performance as a senior market leader.

Supervisory Responsibilities

       No supervisory responsibilities. 

Qualifications
Required Education and Experience

• Bachelors degree in nursing, healthcare administration, business, public health or related field or equivalent experience.
• Minimum 5 years of experience in a physician practice environment
• Experience managing multiple projects, monitoring and reporting progress, and exceeding stakeholder expectations including the ability to manage multiple projects with competing priorities
• 0-2 years of contracting, contract analysis, provider relations, or provider experience in a hospital or physicians office or group setting.
• Ability to develop, motivate and lead teams of cross-functional resources
• MS Project, MS Word, MS Excel
• Bi-lingual fluency in English and Spanish

Knowledge, Skills and Abilities:

• Masters Degree preferred
• Training and/or certification in project management, process improvement, quality improvement, coaching or facilitation, or patientcentered medical home is highly preferred