Job Description

Job Description

Job Description

Our client is an established, growing, national healthcare provider. We are seeking a motivated Field Healthcare Network Development Representative , to serve as the primary strategic liaison between our health care client and their contracted healthcare provider networks in Queens and the Bronx in the New York City metro area. The role is responsible for developing and driving high-level partnerships, cultivating executive-level relationships, and collaborating with clinicians to ensure the delivery of superior member care. This role is instrumental in developing network management strategies and launching strategic initiatives that produce measurable progress on performance improvement and value-based care.

The ideal candidate will have 5+ years of relevant experience in Managed Care, Medical Group operations, Provider Relations, or Quality Improvement. Must have prior experience advising health care providers and physicians using data and metrics to improve performance. A valid driver’s license and ability to travel 30% – 50% (up to 4 days per week) to meet with health care providers in the boroughs of Queens / Bronx in New York City, New York is required.

PRIMARY RESPONSIBILITIES INCLUDE:

Strategic Provider Management

• Performance Consulting: Conduct regular in-person sessions with physicians to analyze performance metrics, provide real-time operational support, and identify clinical improvement opportunities.
• Value-Based Care (VBC) Advocacy: Lead initiatives to align providers with performance-based agreements that incentivize cost-efficiency, quality outcomes, and member health.
• Strategic Planning: Evaluate provider data to develop and execute long-term improvement plans and present detailed Health Benefit Ratio (HBR) analyses during Joint Operating Committee (JOC) meetings.

Data & Education

• Actionable Analytics: Leverage data tools to track performance, offering health care providers actionable feedback to optimize care delivery and hit key performance targets.
• Provider Education: Act as a subject matter expert on Value-Based Performance (VBP) tools, claims submission procedures, EDI solicitation, and web portal utilization.

Operational Excellence & Leadership

• Conflict Resolution: Investigate and resolve high dollar / high-volume claim issues and navigate complex internal / external roadblocks to create long-term operational efficiencies.
• Mentorship: Serve as a lead for external representatives, providing coaching and training to ensure team-wide alignment with health plan standards.
• Executive Influence : Build and maintain C-Suite relationships both internally and externally to influence innovation, provider retention, and member growth.

CANDIDATE REQUIREMENTS INCLUDE:

• Bachelor’s degree in Business, Health Care Management, or closely related field required; Master’s Degree (MPH, MHA, or MBA) is highly preferred.
• 5+ years of relevant experience in Managed Care, Medical Group operations, Provider Relations, or Quality Improvement.
• Demonstrated relationship-building skills and track record of conducting face-to-face, data-driven performance meetings with health care providers and physicians.
• High proficiency in Healthcare Effectiveness Data and Information Set (HEDIS) / Quality measures, cost / utilization metrics, and project management within an Independent Physician Association (IPA) or health plan setting.
• Excellent verbal, written, interpersonal and presentation communication skills and the ability to work as a trusted health care professional. Exceptional ability to synthesize complex clinical and financial issues and communicate to diverse audiences, from clinical staff to executive leadership.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) for use in communication, presentation preparation and analyses & tracking.
• Valid Driver’s License and ability to travel locally up to 4 days per week.
• Key Competencies: Collaborative Work Style, Influencer, Proactive, Problem-Solver, Professional, Resourceful, Results-Focused, Solutions Focused, Self-Motivated, Strategic, Team-Player.
• Legal authorization to work in the U.S. is required. The company will not sponsor individuals for employment visas for this job at this time.

POSITION LOCATION AND TRAVEL REQUIREMENTS:
Field-based role in New York, NY. Must be able to travel locally 30% - 50% (up to 4 days per week) in the boroughs of Queens / Bronx in the New York, NY metro area for meetings with providers and site visits. Minimal overnight travel required.

TEAM RESPONSIBILITY:

Serve as a key team member of the provider engagement team. Collaborate with internal team members and external health care providers. Mentor team members.

K EY RELATIONSHIPS / STAKEHOLDERS :

• Head of Provider Engagement
• Internal Team Members and Subject Matter Experts (SME's)
• External Health Care Providers, Physicians and Health Care Network Representatives

RELOCATION ELIGIBILITY:
No relocation assistance provided. Local, qualified New York City metro area candidates will be given preference and priority. Qualified candidates willing to self-relocate to the New York City metro area will also be considered.

COMPENSATION & BENEFITS INFORMATION:

• Base Salary Range: $105,000 - $120,000, commensurate with experience and qualifications.
• Variable Pay: Up to 8% annual results-based performance bonus.
• Benefits Include: Health & Dental Insurance, Paid Time Off, 401-K with match, FSA, Company Paid Training, etc.
• Company equipment to work remotely from filed or home will be provided.

POSSIBLE COMPARABLE TITLES:

• Clinical Partnership Representative / Associate / Specialist
• Healthcare Business Development Representative / Associate / Specialist
• Healthcare Network Performance Representative / Associate / Specialist
• Healthcare Network Operations Representative / Associate / Specialist
• Healthcare Provider Engagement Representative / Associate / Specialist
• Healthcare Provider Network Representative / Associate / Specialist
• Healthcare Provider Performance Representative / Associate / Specialist
• Healthcare Provider Relations Representative / Associate / Specialist
• Healthcare Provider Success Representative / Associate / Specialist
• Physician Liaison Representative / Associate / Specialist
• Physician Relations Representative / Associate / Specialist
• Strategic Healthcare Account Executive
• Value-Based Care (VBC) Representative / Associate / Specialist

Talent Solution Partners is a full-service Talent Acquisition and Solutions Firm. Our primary focus is the placement of professionals and executives for clients in Healthcare, Consumer Products, Business-to-Business Services and related industries.

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Company Description

Talent Solution Partners is a full-service Talent Acquisition and Solutions Firm. Our primary focus is the placement of professionals and executives for clients in Healthcare, Consumer Products, Business-to-Business Services and related industries.\n\nVisit us at:

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