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
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