PPO Developer

JOB SUMMARY:

The Network Developer is responsible for increasing in-network claims penetration and network revenue through effective contracting and management of contracted Providers within CorVel’s proprietary networks. This individual must combine strong interpersonal and negotiation skills with resourcefulness and aptitude in the medical provider market.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Identify, initiate, follow-up, negotiate, and finalize effective contracts and renegotiation efforts with providers.
• Work jointly with District Manager (or above) and management team to set targets based on client needs and strategic direction for your market, utilizing and accurately interpreting all appropriate analytical data (to include Ceris analytics) in determining the validity of provider participation/nomination.
• Build relationships and interact with providers and share CorVel’s value and differentiators through community involvement, onsite meetings, mailings and other marketing efforts.
• Become a state expert of local compensation rules and regulations relating to the ability to channel patients, reimbursement schedules, PPO reduction limitations, etc.
• Arrange face to face meetings with CorVel management team and top prospects.
• Collaborate with respective National Developer on major hospital/heath system targets.
• Interface with National Database (NDB) Team to add new contracts to the CorVel database.
• Assure appropriate changes/additions/deletions to the CorVel Networks are made by NDB. Responsible to ensure accuracy and timeliness for updated provider information.
• Screen incoming provider applications and agreements for completeness and, when appropriate follow-up with letters and/or telephone calls to obtain incomplete or missing information.
• Research network problems and initiate resolution; promote strong customer service.
• Interact with CorVel clients in providing panel development, stewardship meetings, etc.
• Other duties as assigned.

KNOWLEDGE & SKILLS:

• Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for results, innovative
• Proven track record of delivering concrete results in negotiations
• Excellent written communication skills
• Superb attention to detail and ability to deliver results in a fast paced and dynamic environment.

EDUCATION/EXPERIENCE:

• Undergraduate Bachelor of Arts or Sciences degree, liberal arts or business
• Demonstrated success in provider recruitment
• Two years of sales and/or negotiating experience
• Proficient in Microsoft applications and presentation software

About CorVel

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publically traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.