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This role is responsible for recruiting providers and managing the end-to-end contracting process to ensure timely participation in our network. The position requires a high volume of cold calls, persistent follow-up, and strong organizational skills to move contracts from initiation through execution. The ideal candidate will have negotiation skills, basic contract knowledge, and the ability to manage multiple priorities in a fast-paced environment.
Job Responsibility:
Recruit providers as needed to ensure attainment of network expansion and adequacy targets
Negotiate and execute contracts with larger and more complex, market-based group/system providers
Conduct extensive cold calling to recruit providers and build provider network
Manage the full contracting process, including pre- and post-signature review, language modifications, submission of contract packet to appropriate departments
Collaborate with internal teams to resolve issues and meet network adequacy and expansion goals
Audit, build, and load contracts, agreements, amendments, and/or fee schedules in contract management systems
Conduct research, analysis, and audits to identify issues and propose solutions
Manage contract performance and support development of value-based relationships
Collaborate cross-functionally on provider compensation, pricing development, and reimbursement modeling activities
Attend JOC meetings with assigned health systems
Provide technical expertise for questions related to contracting systems and data
Perform data analysis to assess quality and meaning, identify trends, and visualize data
Requirements:
Minimum 3 years of related experience with knowledge of basic negotiating skills
Proven working knowledge of standard provider contracts, terms, and language
High proficiency with Microsoft Office Suite (Word, Excel, Outlook)
Strong communication skills (written, verbal, and presentation)
Critical thinking, problem resolution, and interpersonal skills
Bachelor's degree desired or equivalent work experience
Nice to have:
Knowledge and experience with Medicaid programs, regulations, and provider requirements
Experience with Quickbase and SharePoint
Ability to identify and capitalize on opportunities to support program delivery
In-depth knowledge of managed care industry practices and competitor strategies
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