New Directions Behavioral Health Provider Specialist in Kansas City, Missouri
Roles & Responsibilities:
This position will be dedicated to the EAP program. The Provider Specialist is responsible for negotiating with out of network providers when identifying a gap in the network. In addition, the Provider Specialist will negotiate temporary provider agreements.
The Provider Specialist is also responsible for backup in paying all EAP provider claims.
• Collaborate on development of provider networks and systems which address integration with physical health providers and offer alternatives to traditional and/or higher levels of care
• Coordination/Development of the networks to meet business needs. (includes case specific recruitment)
• Coordinate the profiling of providers and the implementation of specialized training courses
• Collaborate with Account Management, Customer Service and Clinical to ensure coverage requested by client companies, including research and investigation of claims issues
• Collaborate with Business Development and Account Management in the timely development of network(s) for new business
• Adheres to New Directions Behavioral Health Mission Statement, Core Values, Code of Business Conduct and Compliance Program
• Complies with all Federal and applicable State laws and New Directions Behavioral Health policies regarding privacy, confidentiality and security of health information and other designated information
Education & Experience (Required)
• High school diploma with three years of experience within insurance environment and/or Provider Relations experience, or bachelor’s degree with two years of business experience
• Computer savvy with proficiency working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, etc.)
• Focused and detail-oriented
• Good communication skills (for interaction with team and providers)
• Must be able to travel an estimated 25% of the time, perhaps slightly more. Most travel will be by automobile and could involve occasional overnight stay
• Must have valid driver’s license and proof of insurance
Education & Experience (Preferred):
• Bachelor’s degree with two years of experience in Provider Relations
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.