Provider Relations Coordinator
MTI America is a Medical Solutions Company that offers a collaborative, engaging and energetic work environment where people feel part of a family. Our core values—Excellence, Compassion, Communication, Integrity and Teamwork—guide us daily to work hard and enjoy what we do! We’re committed to growing our company and are always looking to promote from within. This is an ideal time to join our team!
MTI is a network provider of comprehensive, healthcare solutions delivering decades of value to third party administrators, insurance carriers and employers in the workers compensation industry. Our innovative transport, on demand interpreting, diagnostics, physical medicine and dental & hearing programs keep employers’ costs down while streamlining service delivery for the injured employee, claims professional and providers. Service is our priority.
Provider Relations is responsible for working as liaison between providers and organization. Identify, select, and monitor providers and draft and negotiate final contracts. May create processes and procedures to ensure overall quality of provider services. Facilitate development of relationships with providers, maintain relationships for long-term contracts, and mediate performance and scorecard disputes.
- Draw up short term and long-term Contracting Strategy for the development and improvement of MTI America’s provider network.
- Has good understanding of contract negotiation principles.
- Ensures contractual agreements are met.
- Develop alternatives, strategies and plans of action to facilitate the negotiation process.
- Works independently and as part of a team on contract negotiations, renegotiations, contract preparation, provider relations and recruitment.
- Reduce cost of goods sold through contract negotiations and renegotiations of existing vendor contracts.
- Ensure quality components of service delivery and patient/carrier satisfaction with services provided.
- Initially establishes relationships with providers and prepares handoff to account management team.
- Participate in process for continuous credentialing and quality monitoring of assigned accounts.
- Monitors state fee schedules to ensure vendor compliance.
- Works with team to identify margin opportunities by performing analysis on out of network utilization and using data to identify network development opportunities.
- Performs ad-hoc negotiations with out of network vendors and strategically recruits new vendors based on feedback from Operations and Sales.
- Works closely with Internal Audit and Compliance (IAC) department to ensure vendor. compliance with contracts as well as MTI’s billing and other protocols.
- Identifies potential vendors for recruitment into the MTI America’s Management network.
- Identifies white space and targets vendors in those areas for inclusion in the MTI America’s Management network.
- Negotiates all new and existing contracts within your territory.
- Manages contract process including distributing and receiving contracts.
- Acquires credentialing applications at initial contracting.
- Acquires liability and licensure on each provider at initial contracting.
Skills and Expertise:
- Good understanding of ancillary products and services.
- 3+ years’ experience in network development in healthcare required; workers’ compensation preferred.
- General knowledge of the workers compensation industry.
- Requires expert negotiation and communication skills, both written and verbal.
- Excellent verbal and written communication skills to technical and non-technical audiences of various s levels in the organization (e.g. executive, management, individual contributors).
- Excellent problem solving, team and time management skills managing multiple deadlines for self and others.
- Proficiency to operate independently on work that is often confidential in nature.
- High School Diploma or equivalent required. College degree preferred experience
Physical Demands/Work environment:
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Individuals may need to sit or stand as needed. May require walking primarily on a level surface for periodic periods throughout the day. Reaching above shoulder heights, below the waist or lifting as required to file documents or store materials throughout the workday. Proper lifting techniques required. On occasion, may include lifting of up to 5 pounds for files and computer printouts.
- For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands, and fingers speak, and hear.
- Hearing, vision, and talking. Specific vision abilities required by this job include ability see things from a close distance and ability to adjust focus.
- Utilizes fluorescent lighting; noise level is moderate. For the most part ambient room temperatures, lighting and traditional office equipment as found in a typical office.
The Job Description is subject to change at any time MTI America is an Equal Opportunity Employer and a Drug-Free Workplace. By submitting a resume for this position, you authorize MTI America to contact you via phone, email, or text message to coordinate an interview.