Provider Contracts Manager (Healthcare) - OR

About the position

The Provider Contracts Manager (Network Contracting Manager) is responsible for developing, negotiating, and managing contractual, legal and financial arrangements with providers that ensure our patients have superior access to the highest quality, cost-effective providers of healthcare services.

Responsibilities

• Assist with all network contracting activities, including physician, ancillary and hospital contracting.
• Support Network Development & Contracting with payer negotiations and implementations.
• Participate in all new network expansions and future organizational opportunities.
• Acts as a liaison for various contracting and operational projects for hospitals, ancillary providers, and physicians.
• Coordinates managed care contracting for acquisitions and networks.
• Coordinates and produces Monthly Network Contracting Reports.
• Oversees variety of Network Contracting processes.
• Applies approaches and methodologies to accomplish project deliverables, such as analysis, documentation, and training.
• Handles confidential and non-routine information.
• Delivers assigned projects on time and compliant to applicable state and federal regulations. Assure project milestones and deliverables are met.
• Organizes and prioritizes large volumes of information.
• General administrative duties.

Requirements

• Bachelor's Degree preferred or in process of completion or equivalent experience.
• Minimum of five years of specific work experience in managed care contracting including network expansion projects, hospital contracting, primary and specialty physician contracting, and ancillary contracting.
• Well versed in CMS reimbursement methodologies, including capitation, per visit, per diem, DRG, APC, and value-based incentives.
• Robust understanding of Medicare Advantage is highly preferred.
• Prefer national contracting negotiation experience.
• Prefer network operations experience.

Nice-to-haves

• High level of interpersonal skills to handle sensitive and confidential situations.
• Excellent verbal and written skills.
• Ability to interact and communicate with individuals at all levels of the organization and external parties.
• Demonstrated knowledge of variety of computer software applications in word processing, spreadsheets, database, and presentation software (Word, Excel, Access, PowerPoint).
• Ability to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks and demands.
• Excellent planning and coordinating skills.

Benefits

• Opportunity to work in a fast-growing organization.
• Engagement with a physician-led organization focused on wellness guidance.