Responsable Security Operations Center managing daily SOC activities and incident response. Protecting sensitive data and overseeing security strategy at Crédit Agricole Titres.
About the role
- Contract Manager at Network Health managing healthcare provider relationships. Responsible for contract negotiations, relationship management, and health care contract analyses.
Responsibilities
- Successfully manages the Managed Care Contracting prospective, renewal and termination negotiation processes as they relate to: Network Health, HMO/POS; third party administrators and self-funded employers, Accountable Care Organizations (ACO).
- Accountable for establishing and maintaining positive relationships with internal departments, Network Health executive leadership and for any of the following prospective and/or existing external group: Network Health HMO/POS and third-party administrators.
- Serves as the individual accountable for the overall relationship between Network Health and selected contracted providers.
- Specific duties include establishing the initial contact with contracted providers setting and/or maintaining the tone for the desired Network Health provider agreements.
- Conducts managed care contracting related research and analysis including developing compensation/reimbursement structures and contract terms/conditions.
- Evaluates best-fit options for continued negotiations.
- Prepare executive summaries and recommendations.
- Initiates contract implementation process.
- Maintains effective communication throughout contract terms and communicates contract updates and changes as needed.
- Requests audits from the Provider File Specialist and evaluates contracting terms.
- Provides leadership for department, and Network Health special projects
Requirements
- Bachelors degree in a related field is preferred or eight years of equivalent experience may be substituted.
- Minimum of four years of experience in the health care industry (hospital, health insurance, or physician practice).
- Minimum of two years health services negotiation and provider/customer service experience, preferably health insurance and/or provider.
- Advanced health care financial, reimbursement and utilization data and analysis skills.
- Working knowledge of medical terminology, health care billing/coding, reimbursement and insurance benefit methodologies.
- Exceptional customer service/relationship management skills.
- Ability to prioritize multiple tasks and projects.
- Self-guided and motivated to achieve deliverables in a timely fashion.
Benefits
- Health insurance
- Paid time off
- Remote work options
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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