Hybrid Provider – Hospital Contracting Manager

Posted last week

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About the role

  • Serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting.
  • Assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.
  • Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers.
  • Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
  • Initiates and maintains effective channels of communication with matrix partners.
  • Contributes to the development of alternative network initiatives.
  • Supports and provides direction to develop network analytics required for the network solution.
  • Creates and manages initiatives that improve total medical cost and quality.
  • Drives change with external provider partners by assessing clinical informatics and offering consultative expertise.
  • Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
  • Creates healthcare provider agreements that meet internal operational standards and external provider expectations.
  • Responsible for accurate and timely contract loading and submissions.

Requirements

  • Should possess a bachelor’s degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
  • Significant industry experience will be considered in lieu of a bachelor’s degree.
  • 3+ years Managed Care contracting and negotiating experience involving complex delivery systems and organizations required.
  • Experience in developing and managing key provider relationships
  • Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
  • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
  • Intimate understanding and experience with hospital, managed care, and provider business models.
  • Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills.
  • Experience with formal presentations.
  • Customer centric and interpersonal skills are required.
  • Demonstrates an ability to maneuver effectively in a changing environment.
  • Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
  • Knowledge and use of Microsoft Office tools.

Benefits

  • Health insurance
  • 401(k) matching
  • Flexible work hours
  • Paid time off
  • Professional development opportunities

Job title

Provider – Hospital Contracting Manager

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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