Provider Network Director jobs in Charleston, WV

Director of Network Development, Home Care

The CommuniCare Family of Companies currently owns/manages 100 World-Class Healthcare Centers throughout Ohio, Indiana, Missouri, Pennsylvania, Virginia, West Virginia, and Maryland. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living communities.

CommuniCare is currently recruiting for a Director of Network Development for our Home Care division based in West Virginia.

PURPOSE/BELIEF STATEMENT:

The Director of Network Development plays an intricate part in the Executive Leadership Team and leads the Home Care network in improving the patient access experience through provider engagement and referral management. This includes an emphasis on management of Stonerise Home Care payor relations and the patient referral and intake process. This Director of Network Development reports directly to the VP of Operations and will strengthen collaborative relationships across the Home Care and Hospice organization. This candidate must have experience working with Home Health in the Operations capacity and/or the Payor capacity.

WHAT WE OFFER:

As a CommuniCare employee you will enjoy a great team environment, competitive salary, PTO plans, and our outstanding, robust benefits package. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

QUALIFICATIONS AND EXPERIENCE REQUIREMENTS:

• Requires a Bachelor’s Degree in business, healthcare administration, finance, or a relevant field of study.
• 5 years of managed care provider relations, provider contracting, or provider data management experience; Medicare Advantage experience preferred.
• Home Health expansion experience a plus
• Must have experience working with Home Health through Operations or Payor capacity

KNOWLEDGE/SKILLS/ABILITIES

• Must have integrity and a strong ethical compass.
• Must be entrepreneurial, flexible, creative, and naturally curious.
• Must be excited by the opportunity to work within an integrated delivery system.
• Must have a vision, be highly organized, and self-directed.
• Must have strong communication skills and the ability to work effectively with people coming from diverse cultural and professional backgrounds.
• Must haves strong analytic and financial reasoning skills.

JOB DUTIES/RESPONSIBILITIES

• Management of Provider and Vendor network performances, including strategies for adequacy and effectiveness
• Payor Relationships that facilitate contracting and payment.
• Admission and Census targets
• Oversight of Home Health and Hospice Patient Intake
• Reputation of the Home Care and Hospice organization
• Develops and implements strategies in collaboration with Compliance to ensure all state and federal regulatory requirements within the scope and span of control for the department are in the collaboration and best interests of the Home Care and Hospice departments. This includes, but is not limited to:
• Accuracy, timeliness, and adequacy with patient records
• Soundness of provider contracting strategy and approach
• Supports adequateness and effectiveness while providing elements of incentive or value-based purchasing arrangements
• Adheres to and participates in Compliance, Quality assurance, all while directing communication to other key divisions across the Home Health and Hospice enterprise
• Amending provider agreements to meet statutory, regulatory, or business needs of the Home Health and Hospice enterprise

About Us

A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.