Provider Network Development Specialist

Provider Network Development Specialist

The minimum annual salary for this role starts around $65,000; with room for growth based on experience.

CBH is a dynamic organization dedicated to providing access to high-quality, accountable care to improve the health and mental wellness of our members. As part of our growth, we are seeking a detail-oriented Provider Network Development Specialist to join our team. CBH offers a robust compensation and benefits package, including:

• Family Planning, Fertility, Adoption Benefits
• 403B Retirement Plan
• PTO Days/Sick Days
• Wellness Program
• Employee Assistance Program
• Health, Dental, Vision Insurance
• Medical, Prescription Drug Insurance
• Tuition Reimbursement
• Commuter Benefits
• Flexible Spending

Position Overview:

The Provider Network Development Specialist will assist in the necessary functions to ensure CBH's provider network has adequate service delivery capacity to support timely and effective access to behavioral health services and meet network adequacy standards.

Core Expectations:

CBH will hold each employee accountable to the following expectations which align with our mission, vision, and corporate code of conduct.

• Perform key responsibilities as detailed in this job description in a dependable, responsible, and positive manner
• Serve as a role model by exemplifying professional behavior, language, skills, and attire in order to promptly and accurately service the needs of stakeholders and their families
• Assure adherence to CBH policies and procedures so that all work is of the highest quality and delivered in the most culturally competent and cost effective manner
• Promote and manage diversity and acceptance within CBH and with all stakeholders by honoring and respecting their individuality, dignity and rights
• Offer suggestions and develop solutions to help promote effective and efficient work processes and innovative programs
• Actively participate in required meetings and complete all mandatory trainings
• Maintain high levels of advocacy and confidentiality to ensure the success of CBH and our mission

Essential Functions:

• Maintain thorough and complete knowledge of the CBH provider network, including as new initiatives are implemented.
• Understand and correctly apply all administrative processes associated with City of Philadelphia procurement practices.
• Support the start-to-end procurement process to ensure all expectations, actions, and timelines are understood and delivered.
• Liaise with other departments and subject-matter experts to obtain technical content required to prepare procurement in accordance with the proposal timeline.
• Assist in the development of new concepts and strategies to meet providers and members emerging needs.
• Proactively manage assigned projects by creating project timelines, identifying key indicators and additional resources needed to successfully complete the work.
• Assist in identifying gaps and recommend enhancements related to new and/or existing services.
• Develops recommendations based on data review, needs assessments and/or root cause analyses.
• Track progress and communicate project status on a regular basis to all necessary parties.
• Perform other related duties and projects as assigned.
• Ability to travel and work nontraditional work hours when necessary.

Position Requirements:

• Education: Master's degree in Behavioral Health, Public Health, or MBA with a healthcare focus or equivalent work experience
• License/Certification: N/A
• Relevant Work Experience: Minimum of three years of direct experience working in a managed care environment with at least one year of experience working with Medicaid programs with a minimum of two years of supervision experience.

Skills:

• Strong knowledge of the Pennsylvania Medicaid program
• Project Management experience
• Skill in balancing competing priorities and to facilitate collaboration between cross-functional team members at varying levels of the organization
• Advanced critical thinking and analytical skills to interpret sometimes ambiguous requirements
• Encourage and promote active team process engagement and individual ownership
• Exceptional communication (verbal and written) skills
• Strong attention to detail to ensure quality and accuracy in deliverables
• Comfortable with ambiguity and able to set your own direction
• Must work well under pressure and be able to meet aggressive deadlines
• Ability to manage and coordinate multiple projects and deadlines while meeting quality standards
• Intermediate proficiency in Microsoft Outlook, Word, Excel and PowerPoint
• Must have the ability to quickly learn and use new software tools

Core Competencies:

• Teamwork and Collaboration: Build and sustain relationships with co-workers and stakeholders and support efforts and deliverables. Encourage unity and help remove barriers to productivity and success.
• Respect: Treat each other and our members and stakeholders with respect and sensitivity, recognizing the importance of diversity.
• Member Centric: Focus on the needs of our members by providing value-added services, promoting strong relationships and going beyond basic expectations to achieve the best possible outcomes.
• Honesty and Integrity: Be open and honest in all we do. Maintain the highest level of integrity at all times.
• Commitment to Service Excellence: Challenge ourselves to be forward-thinking and committed to providing total member and stakeholder satisfaction, first-in-class service and high quality, innovative programs.
• Compassion and Empathy: Demonstrate a deep appreciation for another's situation and point of view. Pay attention to emotional cues, listen effectively and show an exceptional level of caring about each person's perspectives and circumstances.
• Problem Solving: Build and implement logical solutions to resolving challenges/issues by using individual knowledge and experience while taking resources, constraints and CBH values into consideration.
• Initiative and Self-Directed: Proactively manage time and resources in a way that ensures that all work is done in the most efficient manner while identifying and implementing initiatives without interventions from co-workers, supervisors or stakeholders.
• Flexibility and Adaptability: Adjust approaches and behaviors in order to meet the constantly changing environment head-on and accomplish CBH and individual goals. Strive to adapt to, accept and embrace change within areas of responsibility.
• Communication: Effectively and appropriately share thoughts, ideas and information - both written and oral. Respectfully listen to co-workers and stakeholders to gain a full understanding of issues/situations.

Leadership Competencies:

• Strategic Thinking: Understand and integrate the long-term vision of CBH and focus current activities on what is critical to achieve future success including formulating objectives/priorities and developing and implementing breakthrough ideas.
• Leadership: Effectively manage and guide efforts to address challenges and drive continuous improvement for CBH's programs, services and processes. Develop and implement effective strategies and appropriate interpersonal styles to influence and guide others.
• Employee Development: Recognize and promote the necessity to hire, assess, develop and retain high quality talent. Acknowledge strengths and weaknesses in team members through an ongoing performance management process that provides timely feedback in order to help them develop and enhance performance.

Philadelphia Residency Requirement:

• The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.

U.S. Authorization Requirement:

• CBH does not provide sponsorship for applicants requiring future work authorization. All candidates must be legally authorized to work in the United States without requiring sponsorship now or in the future.

Equal Employment Opportunity:

• We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran