MPN Network Development Consultant

We are seeking a highly motivated and knowledgeable independent consultant or contractor with a proven track record of successfully navigating both new Medical Provider Network (MPN) enrollment and, critically, the reinstatement processes for workers' compensation insurance carriers in California, particularly in situations involving prior rejection. The ideal candidate will possess a deep understanding of MPN regulations, application procedures, and relationship management within the workers' compensation landscape, with specific experience in overcoming past enrollment challenges. This is a critical role focused on strategically expanding our access to patient referrals through targeted MPN inclusion and re-entry.

*This is a remote, part-time position.

What you will do: 

• Strategize and execute plans for enrollment in new target MPNs.
• Develop and implement specific strategies for achieving reinstatement in MPNs where we were previously denied or removed, addressing any lingering concerns or requirements.
• Oversee the preparation and submission of persuasive and comprehensive MPN applications, tailored to both new enrollments and reinstatement efforts, ensuring all required documentation is complete and compliant.
• Act as a primary point of contact with workers' compensation insurance carriers, building rapport and effectively communicating our qualifications, the remediation of prior issues, and our commitment to quality care.
• Ensure all application processes and ongoing requirements adhere to relevant state regulations and MPN guidelines.
• Proactively identify and address any specific obstacles or challenges related to our prior rejections, developing effective solutions and advocating on our behalf.
• Collaborate with our internal team responsible for ongoing network management to ensure seamless integration upon successful MPN inclusion.

Qualifications: 

• Minimum of 5 years of demonstrable experience successfully navigating both initial MPN enrollment and, crucially, reinstatement processes for medical providers in the workers' compensation system in California, including instances of prior rejection.
• In-depth understanding of California workers' compensation regulations, particularly those pertaining to MPNs.
• Proven experience in effectively addressing and overcoming reasons for prior MPN rejection.
• Established relationships and a strong professional network within the workers' compensation insurance carrier community, with experience engaging on sensitive enrollment matters.
• Excellent communication, negotiation, and persuasive skills.
• Strong organizational skills and meticulous attention to detail.
• Ability to work independently and manage projects effectively.
• Proven ability to achieve tangible results in both new MPN enrollment and reinstatement scenarios.

Engagement Terms:

This is a project-based engagement with flexible terms. We are open to discussing project scope, timelines, and compensation based on experience and demonstrated expertise in achieving MPN reinstatement and new enrollment success.