Associate – Network Contracting

Associate – Network Contracting

Requirements

• 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
• 2+ years of experience supporting provider network strategy development and negotiating provider contracts
• 1+ years experience navigating and organizing large data sets such as claim files and provider rosters
• 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support improving opportunities
• Able to travel up to 15%.

Responsibilities

• Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with our overall network adequacy, development and cost management goals.
• Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Serve as a Subject Matter Expert to a small team of contracting specialists and/or analysts, providing guidance and encouraging a collaborative and work environment.
• Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
• Facilitates guidance and mentorship of more junior team members by reiterating strategic goals, providing training and development opportunities, and promoting a collaborative and work environment.
• Supports implementation of contracting policies and workflows; supports identifying when effective and efficient contracting processes need improvement Meet defined metrics and SLAs including but not limited to provider outreach and contract completion.
• Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
• Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to improve deficiencies.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Preferred Qualifications

No preferred qualifications provided.