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Network Development Representative- BH (Metro East)

Expired Job

Meridian Chicago , IL 60602

Posted 3 months ago


Who we are:

Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.

Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

A Day in the Life of a Network Development Representative:

This position is to create an educated and comprehensive Behavioral Health (BH) provider network statewide.


  • Responsible for the prospecting and contracting of all BH providers state wide

  • Responsible for orientations and ongoing education with BH providers.

  • Work with territory reps on any issues (claims, etc.)

  • Review all BH contracts to make sure all providers are either in our system as organizational or credentialed (new)

  • Attend State meetings related to BH as needed

  • Coordinating the entire contracting process for all potential providers, including prospecting, negotiation, credentialing and orientation

  • Collecting all practitioner and ancillary signed contracts, applications and necessary credentialing information. Ensuring MHP's credentialing standards are maintained.

  • Educating providers on MHP's provider policies and procedures

  • Provider network reporting for State expansion requirements

  • Assist contracted MHP providers with access to the Provider Portal. Provide ongoing education on the use and tools of the Provider Portal

  • Provide exceptional customer service to our Provider Network

  • Complete change forms and top sheets when needed to update Provider changes and or additions in MCS (complete and submit appropriate documentation for proper set up in MCS)

  • Assisting with planning and development activities related to BH department

  • Perform other duties as assigned


What you can bring to Meridian:

  • Bachelor's deree required

  • One to three years of provider services or managed care experience is required

  • Thorough knowledge of Practitioner, Hospital, and Ancillary Agreements

  • Thorough knowledge of BH credentialing requirements for all providers

  • Thorough knowledge of BH managed care reimbursement methods

  • Thorough knowledge of BH, Medicaid managed care, reimbursement, and Medicaid/Medicare guidelines

  • Computer skills, including working knowledge of Excel and Oracle software

  • Follow up skills, with a "do whatever it takes" attitude

  • Organizational skills

  • Ability to communicate clearly and concisely both orally and in writing

  • Ability to work as part of a team while maintaining and exceeding individual goals and objectives

What Meridian can offer you:

  • Ourhealthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.

  • Opportunity to work with the industry's leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.

  • Meridian offers 401k matching that is above the national average.

  • Full-time Meridian employees are eligible fortuition reimbursement towards Bachelor's or Master's degrees.

  • Meridian was named

Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.

Equal Opportunity Employer


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Network Development Representative- BH (Metro East)

Expired Job