Preferred bachelor's degree or equivalent experience, One year of related experience in medical network development, Knowledge of the insurance, health, or vision care industry, Proficiency in Microsoft Office and understanding of HIPAA regulations..
Key responsibilities:
Recruit and contract new vision providers and facilities into networks
Make inbound and outbound calls to vision providers for information and recruitment
Negotiate fee schedules and review application materials for completeness
Educate providers on plan designs and resolve complaints or claims issues.
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Our purpose is grounded in the belief that when people can see everything, they hold the power to become anything they set their sights on—in their personal lives, in their communities, and in the world. Powered by Davis Vision and Superior Vision, we are one of the nation’s leading managed vision care companies. Learn more about our team, our expertise, and our commitment to serve.
Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.
As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.
See how you can make a difference with the support of strong leadership and a team environment.
See Everything, Be Anything™.
What are we looking for?
The Network Recruiting Specialist will be responsible for recruitment of vision providers to Versant Health’s networks according to established goals and priorities. This individual will also be responsible for following up with providers undergoing the credentialing process, providing service and education to network physician/providers during the recruitment process, maintenance of the network as required, amongst other duties. This role will require a highly motivated individual with medical surgical recruitment experience, as well as facility contracting experience with excellent negotiations, sales, interpersonal and communication skills and the willingness to work hard to meet goals.
Where You Will Have An Impact
Recruits and contracts new vision providers and facilities into Superior Vision and Davis Vision networks according to established goals and priorities
Takes inbound and makes outbound phone calls to vision providers who have requested information, who have been recruited or who have been nominated by members
Negotiate fee schedules with new and existing vision providers in accordance with corporate goals and standards as required and review for completeness of application materials
Obtain and process application materials and credentialing documents as required and review for completeness
Assist in other projects as necessary
Educate providers on plan designs, processes
Build and maintain relationships with provider community
Work with provider practices to resolve complaints, claims issues as needed
Generate other ad hoc reports as needed
General supervision on completed work and monitoring against established goals
Requires daily use of considerable discretion, judgment and independent problem solving
Work with Director of Medical Network Development identify appropriate recruitment strategies
Have a quiet space conductive to working from home
Other duties as assigned
What’s necessary to do the job?
Preferred bachelor’s degree. High School diploma/GED or equivalent combination of experience and education
One (1) year of related experience
Experience in Medical Network Development
Knowledge and experience in the insurance, health, or vision care industry preferred
Proficiency in MicroSoft Office
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.
Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.
Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.
The wage range for applicants for this position is [$41,600 to $44,720].
All incentives and benefits are subject to the applicable plan terms.
Required profile
Experience
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.