Provider Specialist
BASIC FUNCTION: Effectively negotiate complex, competitive contractual relationships with providers according to prescribed guidelines in support of national and regional network strategies. Manage provider compensation, reimbursement and pricing development activities. Responsible for understanding and managing medical cost issues and initiating appropriate actions.
This position is responsible for the tactical implementation of activities related to developing and maintaining the local community health system and managing IPA, PHO hospital and ancillary services delivery system. Financial goals (e.g.,control medical cost trends, profitability) assure that the delivery system is cost effective, marketable, and stable and offer broad access. Long-term mutually successful physician, hospital and ancillary provider relationships exist.
