The Provider Network Service Development Specialist supports the development and
management of the Provider Network, including assisting with the expansion of
current services, development of new services, and recruiting providers to
fulfill network needs. This position will assist with Alliance’s networks gaps
and needs analysis to help ensure Alliance Health has an adequate provider
network. This position will also assist in the coordination of
cross-departmental initiatives, identified internally or by the State of NC and
assist in the oversight of Provider Network activities related to special
initiatives, with a focus on network adequacy, current services expansion and
new service implementation.
This position is full-time remote. Selected candidate must reside in North
Carolina and be willing to travel to one of the offices for business or onsite
team meetings as needed. Occasional provider site visits may be required within
100 mile radius of Alliance home office.
Responsibilities & Duties
Expand Current Services Network
Assess current network adequacy and recommend expansion of current services
to address gaps in the service array
Research current services that need expansion
Assist in recruiting and retaining qualified and capable providers to assist
in the expansion of current services
Analyze funding incentives and disincentives for best practices
Identify New Services
Identify and recommend new services and supports to address gaps in the
service array
Research new services identified
Assist in recruiting and retaining qualified and capable providers to provide
new services
Analyze funding incentives and disincentives for best practices
Oversee Activities Related To New Service Implementation And Current Services
Expansion
Review and approve the addition of new services to existing providers
Develop Scopes of Work (SOW) and lead the process to finalize the SOW and
gain approval
Ensure all programs, services, and systems are developed in accordance with
Local, State and Federal Performance Standards, and congruent with Alliance
organizational and procedure manuals
Assist in the identification and coordination of internal and external
training needs as it relates to new service development and or current
service expansion
Develop and lead new Provider Collaboratives related to new service, current
service expansion or pilot project implementation
Provide Technical Assistance And Customer Service To Network Providers
Ensure that Evidence Based and Best Practice services for consumers are in
place as identified and are available for consumers
Assist, guide and support providers in the development and maintenance of
comprehensive, outcome focused consumer services
Be knowledgeable of assigned provider contracts with agencies and
organizations in conjunction with Alliance’s Finance and Contract departments
Provide technical assistance and feedback for the use of local and state
funds, new service delivery and adherence to best practice standards and
contractual requirements
Internal and External Collaboration
Collaborate directly with Alliance Health Provider Network Leadership to
review network adequacy data to help identify and expand current services
Arrange and facilitate interdepartmental, provider and State personnel
workgroups
Represent Alliance on State Committees, as applicable
Assist in the coordination of cross-departmental Initiatives as identified
Establish and maintain relationships and collaborations with relevant public,
private, and provider agencies, in order to assure open communications, avoid
misunderstanding and support solution focused atmosphere within the community
Participate in the creation of and attend and or lead newly created Provider
Learning Collaboratives
Out Of Network (OON) Review
Evaluate Out of Network requests based on Network capacity and approve or
deny requests
Collaborate with Internal Departments To Develop Solutions To Identified Needs
Partner with Health Care Project Management Team, Claims, Business
Operations, Medical Management, and other areas to address ongoing needs and
develop solutions
Minimum Requirements
Education & Experience
Bachelor’s degree in a Human Services field from an accredited college or
university and five (5) years progressive post-degree experience in the field of
Mental Health, Substance Use, Intellectual/Developmental Disabilities or
Physical Health;
Or
Master’s degree in Human Services from an accredited college or university with
three (3) years post graduate experience in the field of Mental Health,
Substance Use, Intellectual/Developmental Disabilities or Physical Health.
Preferred:
Previous Provider Network experience
Previous Project Management experience
Previous Network Adequacy analysis experience and development of new services
and programs
Licensure and/or certification in area served is preferred
Knowledge, Skills, & Abilities
Knowledge of Alliance’s goals, targets, and outcomes in relation to the
responsibilities of the Provider Network Operations department
Knowledge of all disability areas including Mental Health, Substance Use and
Developmental/Intellectual Disabilities
Knowledge and understanding of principles, concepts, and Best Practices used
in the treatment, habilitation and support of individuals with needs in any
of the disability areas
Knowledge and understanding of the different systems that impact Providers
Microsoft Office suite, including Excel
Proficient with database maintenance
Exceptional interpersonal skills
Highly effective Communication skills
Problem solving skills
Organizing skill
Conflict resolution skills
Effective public speaking and training skills
Strong mediation skills in order to facilitate collaboration and positive
relationships
High Level of diplomacy and discretion to effectively negotiate and resolve
issues independently
Ability to build relationships
Ability to make prompt decisions based upon relevant facts
Ability to review and analyze data in an effort to evaluate program
effectiveness, progress, problems, and system performance
Ability to work effectively with others internally and externally
Ability to effectively identify problems, and initiate solutions
Ability to take initiative and utilize critical thinking
Salary Range
$69,592-$88,729/Annually
Exact compensation will be determined based on the candidate's education,
experience, external market data and consideration of internal equity.
Employment for this position is contingent upon a satisfactory background check,
which will be performed after acceptance of an offer of employment and prior to
the employee's start date.