Skip to main content
Provider Relations-Networking-Contracting WellCare - Provider Administration & Support Careers

Network Development Representative Job

Full Job Title: *Network Development Rep - Orlando

Job Number: 1703224

Location: Orlando, FL

Date Posted: 7-13-2017

Manages physician contracting, network development and provider relations for developing, executing and maintaining a provider network strategy. Works in concert with medical management and sales developing actions to meet market growth and medical cost targets. Provides service and education to network physicians/providers.

Essential Functions:
  • Contracts and negotiates with primary care, specialty physicians and ancillary providers for all product lines in assigned markets.
  • Facilitates network growth by developing and maintaining relationships with non-participating providers to drive business results within a specific geographic area.
  • Identifies strategies to achieve Medical Expense Initiatives (MEI).
  • Performs ongoing research to identify new providers or areas of expansion in assigned market.
  • Responds to provider's contract requests and inquiries.
  • Analyzes network gaps and identifies providers to contract.
  • Reviews and amends provider's contracts when necessary.
  • Evaluates contracted network to ensure functionality.
  • Assesses performance and contract rates of providers to ensure our network is cost efficient.
  • Researches and develops relationships with non-contracted providers.
  • Collects credentialing and required documents for newly contracted providers.
  • Strategies for membership growth and retention.
  • Performs special projects as assigned

*LI-RR1

Candidate Education:
  • Required A Bachelor's Degree in a related field
  • Required or equivalent work experience directly related to Network Development or Provider Relations with demonstrated ability to perform the job duties
Candidate Experience:
  • Required 2 years of experience in Provider Relations, Network Management, Hospital Contracting or related Provider Services position with demonstrated ability to perform the level of duties of the position
  • Required 1 year of experience in managed care
  • Required Other Previous contracting experience
Candidate Skills:
  • Intermediate Demonstrated written communication skills
  • Intermediate Demonstrated negotiation skills
  • Intermediate Knowledge of healthcare delivery
  • Intermediate Demonstrated customer service skills
  • Intermediate Ability to represent the company with external constituents
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Intermediate Ability to multi-task
  • Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
  • Intermediate Ability to work independently
  • Intermediate Ability to work within tight timeframes and meet strict deadlines
  • Intermediate Demonstrated analytical skills
  • Intermediate Demonstrated organizational skills
Licenses and Certifications:
A license in one of the following is required:
Technical Skills:
  • Required Intermediate Microsoft Word
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft Outlook
Languages:

Back to top

Join Our
Talent Network

and receive job alerts
Click Here
Last Updated On: 12/9/2015