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Director Provider Network Development Jobs in Missouri

The ALS Association

Director, Development

Kansas City, MO · On-site

$77K - $96K/yr

... network of care and certified clinical care centers, and advocates for better public policies for ... Provide volunteer support through face-to-face meetings, phone and email contact, speaking ...

Washington University of St. Louis

$58K - $99K/yr

Collaborates across marketing, communications, analytics, digital strategy, clinical leadership, access, operations, and network development teams to align provider engagement initiatives with ...

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Director Provider Network Development information

What are some common challenges faced by a Director of Provider Network Development, and how can they be addressed?

A Director of Provider Network Development often encounters challenges such as negotiating favorable contracts with providers, ensuring network adequacy, and balancing cost control with quality of care. Successfully addressing these issues requires strong relationship-building skills, an in-depth understanding of healthcare regulations, and the ability to analyze market trends. Collaborating closely with legal, compliance, and analytics teams can help streamline contract negotiations and maintain a competitive, high-performing network. Continual professional development and staying current with industry changes are also key for long-term success in this role.

What is the difference between Director Provider Network Development vs Provider Network Manager?

AspectDirector Provider Network DevelopmentProvider Network Manager
CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentStrategic planning, high-level decision making, cross-department collaborationOperational management, provider relations, network oversight
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, healthcare providers, insurance firms
Search & Comparison IntentStrategic development, network expansion, leadership rolesOperational management, provider relations, network maintenance

The main difference is that the Director Provider Network Development focuses on strategic growth and high-level planning of provider networks, while the Provider Network Manager handles day-to-day operations and provider relations. Both roles require industry knowledge and relevant certifications, but their scope and responsibilities differ significantly.

What are the key skills and qualifications needed to thrive as a Director of Provider Network Development, and why are they important?

To thrive as a Director of Provider Network Development, you need a deep understanding of healthcare networks, contract negotiation, and provider relations, typically supported by a bachelor’s or master’s degree in healthcare administration or a related field. Familiarity with healthcare analytics platforms, provider management systems, and knowledge of payer-provider contract regulations are crucial. Strong leadership, relationship-building, and strategic communication skills set top performers apart. These competencies are vital for building robust provider networks, ensuring compliance, and driving organizational growth in a competitive healthcare environment.

What does a Director of Provider Network Development do?

A Director of Provider Network Development is responsible for building, maintaining, and optimizing relationships with healthcare providers, such as hospitals and physician groups, on behalf of insurance companies or health plans. They negotiate contracts, ensure providers meet quality and cost standards, and help expand the provider network to meet organizational goals. This role often involves analyzing network performance, identifying gaps in coverage, and collaborating with internal teams to improve service delivery and member satisfaction.
What are the most commonly searched types of Provider Network Development jobs in Missouri? The most popular types of Provider Network Development jobs in Missouri are:
What are popular job titles related to Director Provider Network Development jobs in Missouri? For Director Provider Network Development jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Director Provider Network Development jobs in Missouri look for? The top searched job categories for Director Provider Network Development jobs in Missouri are:
What cities in Missouri are hiring for Director Provider Network Development jobs? Cities in Missouri with the most Director Provider Network Development job openings:
Director Provider Network Development jobs near you
Data Management Specialist

Data Management Specialist

Integrated Resources INC

Maryland Heights, MO

Contractor

Re-posted 18 days ago

Job description

Job Description

JOB SUMMARY:

Responsible for timely and accurate data entry and maintenance of provider records or credentialing and contract information in multiple databases. Researches and resolves questions and complaints, and ensures that information in all databases is accurate and properly configured to support operations.

Requirements/Certifications:

  • HS Diploma/GED
  • Ability to type 45-50+ words per minute. Other standard office equipment including telephone, copy machines, personal computer software and mainframe/LAN data systems.
  • Must possess a high level of technical aptitude and be able to organize and manage information in multiple system environments; manage multiple priorities, pay close attention to detail as well as be proficient in word processing and spreadsheet applications.
  • Proven customer service skills and the ability to successfully analyze and procure solutions to problems in a fast paced production based environment.
  • 1-2 years' experience in customer service, data management, communications, or credentialing verifications required.
  • 1 or more years' experience in a behavioral health or related industry.
  • -Managed care or other healthcare network development experience preferred.

ESSENTIAL FUNCTIONS:

  • Performs review, correspondence and timely, accurate record set-up and data entry.
  • Supports internal auditing process to ensure data accuracy and integrity.
  • Researches and resolves issues and ensures systems are updated, timely, appropriately and accurately.
  • Responds to requests to update or change information and ensures that all changes are made within operational guidelines and accurately support all other systems related functions.
  • Researches and responds to providers and other internal staff regarding complex inquiries.
  • Develops solutions and communicates outcomes by telephone and in writing.
  • Supports the implementation of new business by ensuring providers are appropriately and accurately loaded in all applicable systems.
  • Records daily activities using electronic and manual systems as directed.
  • Provides consultation and information to area offices regarding the composition of the provider network or specific provider statuses.
  • Forwards provider requests for network inclusion to the area offices for review and approval.
  • Assists representatives with detailed information in order to answer provider questions and returns provider calls, as requested, to communicate resolution and/or appropriate course of action.
  • Performs other duties and special projects as assigned.
Additional Information

All your information will be kept confidential according to EEO guidelines.

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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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