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Director Provider Network Development Jobs in Pennsylvania

Dynamic Campus, Inc.

Network Administrator

Reading, PA · On-site

Provide the Technical Director and CIO with budgetary requirements for hardware and software needed to support network administration across all sites. * Stay current with technological developments ...

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Director Provider Network Development information

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 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 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 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 popular job titles related to Director Provider Network Development jobs in Pennsylvania?

For Director Provider Network Development jobs in Pennsylvania, the most frequently searched job titles are:

What job categories do people searching Director Provider Network Development jobs in Pennsylvania look for?

The top searched job categories for Director Provider Network Development jobs in Pennsylvania are:

What cities in Pennsylvania are hiring for Director Provider Network Development jobs?

Cities in Pennsylvania with the most Director Provider Network Development job openings:

Director Provider Network Development jobs near you

Provider Network Account Executive

Integrated Resources INC

Harrisburg, PA • On-site

Full-time

Re-posted 12 days ago

Job description

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

The Account Executive I is responsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers. The Account Executive conducts orientation sessions, makes education visits, functions as a pro-active practice account leader and coordinates resolution of provider issues.

Qualifications

         Valid Driver's License

         Current Auto Insurance

         Minimum of 3 years in the managed care/health insurance industry-Required

         1-2 years Medicaid experience-Preferred

         Minimum of 1 year in a Provider Services position-Required

         Previous experience working with healthcare providers-Required

         Previous provider relations experience preferred-Highly desired

Additional Information

Thanks

Warm Regards,

Kavita Kumari


Integrated Resources, Inc

Direct: (732)-844-8726

Integrated Resources logo

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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