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As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. The Senior Provider Network Contracting Manager reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost initiatives.
Job Responsibility:
Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers
Collaborates cross-functionally to develop provider compensation and pricing strategies
Manages contracts through language and compliance reviews
Serves as a liaison to internal colleagues to interpret contracts, drive cost savings, resolve claims and other service issues
Requirements:
A minimum of 3 years work experience in a provider contracting or provider relations role
Proven working knowledge of physician reimbursement methodologies and contracting strategies
Strong communication, critical thinking, project management and problem-solving skills
A willingness to actively interact with providers and have complex conversations
Working knowledge of Microsoft applications
Adept at negotiating complex healthcare provider contracts
Bachelor's degree preferred or a combination of professional work experience and education
Nice to have:
Medicaid and/or behavioral health experience
Working knowledge of QuickBase, QNEXT, PRMS and KIT systems
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