Senior Network Representative; remote - Pittsburg or Cleveland territory

Position Summary

Senior Network Representative – Remote (must be located in Ohio or Pennsylvania). The Senior Network Representative leads contracting, negotiations, recruitment, expansion, and education within assigned territories, working closely with leaders and senior leadership to secure high-level contracts and deliver education and support to providers.

• Handle high-level contracting and renegotiations with large strategic provider groups and PHOs in existing and future markets.
• Lead contracting for opening new expansion markets and maintain ongoing provider education and relationships.
• Conduct high-level provider education in‑services, monitor incentive payments, comprehensive payments, and risk arrangements.
• Develop PowerPoint presentations for provider education trainings and recruitment seminars.
• Attend quarterly Health Plan Sales meetings, submit monthly recruitment reports, and present on key recruitment activity.
• Define new market expansion areas through research and high-level reporting to compile strategic goals.
• Travel to multiple onsite visits to cover all geographic footprint (up to 50% of time, including potential overnights).
• Work closely with Senior Network Operations Specialist and Senior Credentialing Specialist to ensure timely and accurate contract updates.
• Liaise for providers and credentialing to ensure delegated agreements are executed.
• Partner with Provider Relations Rep and Network Rep to provide training, coaching, and mentoring.
• Assist with high-level audit and special contract projects meeting strict timelines.
• Develop contract and reimbursement manuals for consistency and accuracy.
• Communicate with providers regarding substantial changes in benefits or policy changes.
• Handle escalated provider issue management cases, payment issues, balance billing, and compliance matters.

• Bachelor’s degree or equivalent combination of education and experience.
• 5+ years of experience in provider relations and health care, including provider contracting (physician, facility, and ancillary contracts).

• Valid driver’s license (no restricted or suspended license).

• Advanced knowledge of managed care contracting and reimbursement methodologies.
• Understanding of health plan functions and activities.
• Proficiency in Microsoft Word, Excel, and Access.
• Superior verbal and written communication skills.
• Strong analytical, negotiation, and presentation skills.
• Attention to detail, ability to organize and execute multiple activities simultaneously.
• Problem-solving and collaborative teamwork skills.
• Ability to work independently and travel with potential overnights at least 50% of the time.

We are an equal opportunity/affirmative action employer. Martin’s Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact job inquiries.

This position is not eligible for immigration sponsorship.