Hybrid Contract Manager

at Network Health WI

• Job title: Contract Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Menasha, United States

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