The Network Performance Advisor (NPA) serves as a key point of contact and liaison between assigned strategic providers and various departments within WellCare, including Quality, Operations, Finance, Health Services and other shared services departments. The NPA is responsible for ensuring white glove service to the providers. The NPA will develop and execute the strategy for their assigned providers, including building strong working relationship; building trust, maintaining high provider satisfaction and helping providers improve their performance. The NPA will be responsible for the provider's overall performance.
Department: Provider Relations
Reports to: Sr Mgr, Network Management
Additional Responsibilities:Candidate Education:
- Owns and manages the relationship and performance of key provider groups.
- Influences provider behaviors to drive improvements in quality, provider & member satisfaction, optimizing member outcomes and maximizing shared savings.
- Analyzes, interprets, and communicates financial, quality, and performance reports to key provider groups.
- Establishes and maintains cross-functional communication with internal departments.
- Collaborates with internal cross-functional team to support provider performance and satisfaction departments.
- Has a thorough understanding of Risk and Value-Base Contracting.
- Plans, prepares, and executes effective group meetings/discussions with proper objectives and outcome.
- Understands Provider Engagement Model, including role & account management responsibilities.
- Builds rapport and trust with provider groups.
- Executes strategy for membership growth and retention.
- Executes strategy for provider performance management and satisfaction.
- Executes network expansion strategy in collaboration with Sales and Marketing.
- Special projects as assigned or directed.
- Required A Bachelor's Degree in Health Care, Business, Finance or any other field OR equivalent work experience in Network Management/Network Development, Provider Relations, Risk and /or Value Base Contracting
- Required 5 years of experience in Network Management/Network Development, Provider Relations, Risk and/or Value Base Contracting, managed care organization
- Required 2 years of experience in Account Management or management experience
- Required Other
Licenses and Certifications:
- Advanced Other Ability to establish and manage multi-disciplinary meeting approach with key provider groups
- Advanced Other Ability to communicate and effectively influence provider's performance
- Advanced Other Ability to operate as lead point of contact for key provider groups
- Advanced Other Ability to build and maintain strong and long lasting partnerships with key provider groups
- Intermediate Other Ability to manage and work under pressure
- Advanced Other Creates and maintains meaningful & proactive communication with provider groups
- Intermediate Other Manage Provider's experience and satisfaction with health plan
- Advanced Other Ability to forecast, track, and monitor provider performance
- Advanced Other Strong interpersonal skills that build rapport and trust with provider groups
- Advanced Other Excellent cross-functional communication with internal departments (OAR, QPA, Case Management, Field Finance)
A license in one of the following is required:
- Required Advanced Microsoft Excel
- Required Advanced Microsoft Outlook
- Required Advanced Microsoft Word