Provider Network Management Specialist

Community Behavioral Health
Published
October 17, 2020
Location
Philadelphia, PA
Category
Job Type

Description

Position Overview: 

Provider Network Management Specialist will assist in the in necessary functions to ensure CBH’s provider network has adequate service delivery capacity to support timely and effective access to behavioral health services and meet network adequacy standards.

Essential Functions

  • Maintain thorough and complete knowledge of the CBH provider network, including as new initiatives are implemented.
  • Understand and correctly apply all administrative processes associated with City of Philadelphia procurement practices.
  • Support the start-to-end procurement process to ensure all expectations, actions, and timelines are understood and delivered.
  • Liaise with other departments and subject-matter experts to obtain technical content required to prepare procurement in accordance with the proposal timeline.
  • Assist in the development of new concepts and strategies to meet providers and members emerging needs. 
  • Proactively manage assigned projects by creating project timelines, identifying key indicators and additional resources needed to successfully complete the work.
  • Assist in identifying gaps and recommend enhancements related to new and/or existing services. 
  • Develops recommendations based on data review, needs assessments and/or root cause analyses.
  • Track progress and communicate project status on a regular basis to all necessary parties.
  • Perform other related duties and projects as assigned. 
  • Ability to travel and work nontraditional work hours when necessary. 

Position Requirements: 

  • Education: Master’s degree in Behavioral Health, Public Health, or MBA with a healthcare focus or equivalent work experience 
  • License/Certification: N/A
  • Relevant Work Experience: Minimum of three years of direct experience working in a managed care environment with at least one year of experience working with Medicaid programs.
  • Skills:
  • Strong knowledge of the Pennsylvania Medicaid program
  • Project Management experience 
  • Skill in balancing competing priorities and to facilitate collaboration between cross-functional team members at varying levels of the organization 
  • Advanced critical thinking and analytical skills to interpret sometimes ambiguous requirements 
  • Encourage and promote active team process engagement and individual ownership
  • Exceptional communication (verbal and written) skills
  • Strong attention to detail to ensure quality and accuracy in deliverables
  • Comfortable with ambiguity and able to set your own direction 
  • Must work well under pressure and be able to meet aggressive deadlines
  • Ability to manage and coordinate multiple projects and deadlines while meeting quality standards 
  • Intermediate proficiency in Microsoft Outlook, Word, Excel and PowerPoint
  • Must have the ability to quickly learn and use new software tools

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