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Individual contributor role negotiating contracts with physician groups in the North Florida Market for Medicare, Commercial, and IFP lines of business. Responsible for managing contract performance to support network quality, availability, and financial goals while collaborating cross-functionally on provider compensation and pricing activities.
Job Responsibility:
Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with physician groups in the North Florida Market
Manages contract performance in support of network quality, availability, and financial goals and strategies for all lines of business
Recruits providers as needed to ensure attainment of network expansion and adequacy targets
Collaborates cross-functionally to contribute to provider compensation and pricing development activities
Provides network development, maintenance, and refinement activities and strategies
Assists with the design, development, management, and or implementation of strategic network configurations
Ensures resolution of escalated issues related to claims payment, contract interpretation and parameters
Requirements:
3-5 years of related experience
Proven and proficient managed care network negotiating skills
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills
Proven ability to influence and collaborate with providers and partners at all levels
Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
Must be well versed with the provider relations
Must reside in the state of Florida
Bachelor's Degree or equivalent professional work experience
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