Network Contracting Specialist
Location
United States
Posted
93 days ago
Salary
$75K - $95K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Network Contracting Specialist
Curative HR LLC
Duties And Responsibilities - Manages contract negotiations with physicians and physician groups in assigned area. - Conducting several negotiations simultaneously to meet growth demands. - Proactively builds relationships that nurture provider partnerships to support the local market strategy. - Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, Claims, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing. - Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position. - Identify and manage initiatives that improve total medical cost and quality. - Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. - Assists in resolving elevated provider service complaints. Research problems and negotiate with internal/external partners/customers to resolve complex and/or escalated issues. - Manages key provider relationships and is accountable for critical interface with providers and business staff. - Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape. - Partner with Regulatory Affairs to ensure all network filings are timely and accurate. - Performs other duties as assigned Position Requirements - Bachelor’s degree or equivalent experience in related field, plus 3+ years of work experience within provider contracting and/or health insurance - Experience with physician and physician group contracting and negotiations - Experience negotiating delegated credentialing agreements - Experience in developing and managing key provider relationships including senior executives - Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners - Intimate understanding and experience with larger, more complex integrated delivery systems managed care, and provider business models - Team player with proven ability to develop strong working relationships within a fast-paced organization - The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations - Customer centric and interpersonal skills are required - Superior problem solving, decision-making, negotiating skills, contract - language and financial acumen - Remote with occasional travel (5-10%) - Existing relationships with physicians and physician groups in Texas is highly recommended
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