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Network Development Representative- Behavioral Health (Chicago, IL) | Network Development Represe 1

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Network Development Representative- Behavioral Health (Chicago, IL)

Chicago, IL

OverviewWho we are: Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry. We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide. Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional background and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities. A Day in the Life of a Network Development Representative: This position is to create an educated and comprehensive Behavioral Health (BH) provider network statewide.ResponsibilitiesResponsible for the prospecting and contracting of all BH providers state wideResponsible for orientations and ongoing education with BH providers.Work with territory reps on any issues (claims, etc.)Review all BH contracts to make sure all providers are either in our system as organizational or credentialed (new)Attend State meetings related to BH as neededCoordinating the entire contracting process for all potential providers, including prospecting, negotiation, credentialing and orientationCollecting all practitioner and ancillary signed contracts, applications and necessary credentialing info. Ensuring MHP’s credentialing standards are maintained.Educating providers on MHP’s provider policies and proceduresProvider network reporting for State expansion requirementsAssist contracted MHP providers with access to the Provider Portal. Provide ongoing education on the use and tools of the Provider PortalProvide exceptional customer service to our Provider NetworkComplete change forms and top sheets when needed to update Provider changes and or additions in MCS (complete and submit appropriate documentation for proper set up in MCS)Assisting with planning and development activities related to BH departmentPerform other duties as assignedRequirementsWhat You Can Bring to Meridian:Bachelor’s degree required or five years' equivalent background.One to 3 years of provider services or managed care background is requiredStrong knowledge of Practitioner, Hospital, and Ancillary AgreementsStrong knowledge of BH credentialing requirements for all providersStrong knowledge of BH managed care reimbursement methodsGood knowledge of BH, Medicaid managed care, reimbursement, and Medicaid/Medicare guidelinesTechnical skills, including working understanding of Microsoft excel and Oracle softwareFollow up skills, with a “do whatever it takes” attitudeManagement expertiseExpertise to communicate clearly and concisely both orally and in writingExpertise to work as part of a team while maintaining and exceeding individual goals and objectives What Meridian can offer you:Our healthcare benefits include a variety of plans that are effective on the 1st day of employment for our new full time teammates. Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.Meridian offers 401k matching that is above the national average. Full time Meridian employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian. Equal Opportunity Employer#MSTR
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More About this Listing: Network Development Representative- Behavioral Health (Chicago, IL)
Network Development Representative- Behavioral Health (Chicago, IL) is a Other Jobs Network Development Represe Job at Meridian located in Chicago IL. Find other listings like Network Development Representative- Behavioral Health (Chicago, IL) by searching Oodle for Other Jobs Network Development Represe Jobs.