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Organizes, directs and controls the operations of an integrated physician/hospital network that provides contracting opportunities for managed care payers.: Organizes, directs and controls the entire provider network function including network development, contracting, credentialing, provider relations, and provider services. Establishes physician and hospital recruitment priorities, determines compensation methodologies and negotiates contracts. Ensures a comprehensive, cost-effective, and accessible provider network. Negotiates, administers, extends, terminates, and renegotiates contracts. Formulates and coordinates proposals. Coordinates activities of workers engaged in formulating bid proposals. Evaluates or monitors health outcome and contract performance to determine necessity for amendments or extensions of contracts, and compliance to contractual obligations. Approves or rejects requests for deviations from contract specifications. Arbitrates claims or complaints occurring in performance of contracts. May serve as liaison officer to ensure fulfillment of obligations by contractors. Develops and maintains a network of relationships with leaders involved in the integrated network of physicians.

Top Provider Network Contracting Executive

Provides executive leadership and coordination over Provider Network Contracting operations to include development and implementation of strategic plans that provide sound provider interaction and contracting.: Responsible for the research, policy development, contract development and expansion of the provider network. Plans, organizes and directs the Provider Network Contracting department. Organizes, controls, and evaluates the implementation of strategic plans that provide strong provider relations and contracting. Formulates and administers departmental policies. Plans, organizes, implements and evaluates outcomes of the department’s strategic plans. Develops strategic initiatives and transforms initiatives into action plans. Develops and fosters effective collaboration between departments and other affiliated services to ensure an integrated approach to provider network contracting. Develops new strategies to enhance service and improve overall performance. Develops and maintains administrative and regulatory compliance systems. Reviews budgetary recommendations, and manages and monitors the departmental budget. Hires, develops and motivates a qualified staff. An advanced degree is typically required for this position with seven years of provider relations and contracting experience in managed care.

Network Development Director

Directs a department responsible for developing and maintaining an integrated network of providers, hospitals, and affiliated health programs within a designated area. Develops and maintains the operations of an integrated network of providers, hospitals, and affiliated health care programs. Establishes and operates affiliated clinical programs with community providers which generate income and positions the organization as the preferred provider of care. Typically requires a bachelor's degree with seven years of related managed care administration experience and strong capitation negotiating skills.: Negotiates with providers including medical groups, IPAs, hospitals, mental health providers, and ancillary services. Drafts contracts and communication to both legal department and contracted entities. Identifies, plans, and develops network needs for expansion in both existing and additional service areas. Actively recruits providers and facilities within a designated territory. Analyzes existing medical group and hospital/facility rate structures to ensure competitive market rates. Provides network servicing, in-service training, visits to provider groups, and provider relations problem resolution, focusing on contract issues. Works with the Member Services Department in resolution of claims issues, training, and response to provider questions and problems. Provides administrative, management, and operational oversight to the network. Develops, monitors, and oversees implementation of strategic and operational plans specific to network activities. Monitors the performance of network activities and provides related timely reports. Designs and implements programs to maintain positive relationships between health plans, physicians, and providers. Responsible for hiring, developing, and managing a qualified management staff concerned with the development and maintenance of the health care network. Prepares, manages, and monitors the departmental budget.

PC Supervisor

Supervises and coordinates activities of PC specialists and related staff. Responsible for providing support, technical assistance, and/or training to all end users and company locations on personal computer hardware and software. Supervises the installation, modification, minor repairs to personal computer hardware, and technical support and training on software systems. Most companies prefer at least a two-year degree, plus excellent working knowledge of personal computers and peripherals is required; however, some organizations may accept equivalent education and experience combined. Is required to be adept in activities of PC specialists.: Analyzes and resolves work problems, or assists employees in solving work problems. Attends technical conferences and seminars to keep abreast of new software and hardware product developments. Studies schedules and estimates time, cost, and labor estimates for completion of job assignments. Develops and implements methods and procedures for monitoring work activities, such as preparation of records of expenditures, progress reports, etc., in order to inform management of current status or work activities. Analyzes department budget to identify budget increases and/or reductions. Interprets company policy to employees and enforces safety regulations. Refers major hardware problems to service personnel for correction. Examples of activities supervised include, but are not limited to, loading specified software packages, such as operating systems, word processing, or spreadsheet programs into computer; instructing users in use of equipment, software, and manuals; answering client's inquiries in person and via telephone concerning systems operation; diagnosing system hardware, software, and operator problems; and recommending or performing minor remedial actions to correct problems based on knowledge of system operation. May recruit, hire, train staff, evaluate employee performance, and recommend or initiate promotions, transfers, and disciplinary action.

Network Consultant

Leads network related consultancy, solution, design, and implementation activities. Develops and implements complex single or multi-product network/systems projects. Develops solutions or customizes existing network/systems to meet customer needs.: Presents and communicates technical ideas and solutions. Develops project plans and estimates for time frames, quality, and resources required for successful implementation. Establishes criteria for deliverability, performance, maintenance, design, and cost and makes adjustments as needed throughout the project. Prepares regular status reports. Develops training materials and conducts training for internal and/or external customers. Documents technical builds, configurations, and scopes of work for customer projects. Troubleshoots issues relating to network, server, messaging, etc. Demonstrates knowledge of networking technologies including LAN's, VLAN's, and WLAN's and various modern network topologies including Internet, intranets, and extranets.

Network Planning Manager

Manages the long-term strategic planning, development, and installation of digital network systems, such as frame relay, ISDN, and Internet services, to ensure network capacity for current and future organizational requirements. Manages the activities of a group of network planning supervisors, or similar personnel, to monitor all activities of the network facilities. Typically requires eight to ten years of increasingly responsible experience in network planning. This position typically reports to director level.: Designs, develops, maintains, and communicates project plans and schedules for network installations with prioritized requirements. Develops and implements standards and processes for system analysis and support. Manages the evaluation of software and hardware systems to ensure compatibility across the network. Coordinates the acquisition, analysis, and installation of hardware and software at remote locations. Develops and implements policies in support of network and data systems for the organization. Manages and coordinates training of staff responsible for planning and installation of network software and hardware.

PC Specialist

Installs, modifies, and makes minor repairs to personal computer hardware and software systems, and provides technical assistance and training to system users. Answers client's inquiries concerning systems operation; diagnoses system hardware, software, and operator problems; and recommends or performs remedial actions to correct problems based on knowledge of system operation. There are no specific educational requirements, but excellent working knowledge of personal computers and peripherals is required.: Inspects personal computer equipment and reads order sheet listing user requirements to prepare computer for delivery. Installs or assists service personnel in installation of hardware and peripheral components, such as monitors, keyboards, printers, and disk drives on user's premises, following design or installation specifications. Loads specified software packages, such as operating systems, word processing, or spreadsheet programs into computer. Enters commands and observes system functions to verify correct system operation. Instructs user in use of equipment, software, and manuals. Replaces defective or inadequate software packages. Refers major hardware problems to service personnel for correction. Attends technical conferences and seminars to keep abreast of new software and hardware product developments.

PC Maintenance Technician

Installs and repairs computer systems and peripheral, using hand tools, power tools, and electrical and electronic test equipment and following electrical code, manuals, specifications, schematic diagrams, and blueprints. : Installs power supply wiring and conduit for newly installed equipment, using hand tools and voltage tester and following electrical code and blueprints. Connects power supply wires to machines and equipment, and connects cables and wires between machines and equipment, using hand tools and test equipment and following manuals, schematic diagrams, and blueprints. Diagnoses and replaces damaged or broken wires and cables and malfunctioning electrical apparatus. Tests malfunctioning machinery, and discusses malfunction with workers, supervisors, or other maintenance workers to diagnose malfunction. Replaces faulty components of machines using hand tools. May diagnose and replace faulty electronic components, such as printed circuit boards, using test equipment and following manuals, specifications, and schematic diagrams.

Maintenance Technician PC

Network Communications Technician

Responds to software and hardware problems, configures, implements, installs, repairs, and maintains data, voice, and network communications systems, using hand tools and software and hardware testing instruments and techniques. Implements recommended equipment modifications and enhancements in accordance with user request and business objectives. : Reviews work orders to move, change, install, upgrade, repair, or remove data communications equipment. Reads technical manuals to learn correct settings for equipment. Measures, cuts, and installs wires and cables. Splices wires or cables, using hand tools or soldering iron. Connects microcomputer or terminal to data communication lines, using hand tools and following diagrams and manuals. Disassembles equipment and inspects and tests wiring to locate and repair problem. Tests communication lines to ensure that specifications are met, using testing instruments such as voltmeter and data scope. Enters commands into computer to test equipment. Reads messages on computer screen to verify that data is being transmitted between locations according to specifications. Maintains working knowledge of current technologies, applications, and industry trends. May plan layout and installation of data communications equipment. May demonstrate use of equipment.

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