Senior Provider Contracting Professional - AZ, LA, MS Markets
: Job Details :


Senior Provider Contracting Professional - AZ, LA, MS Markets

CenterWell

Location: Washington,DC, USA

Date: 2024-11-30T06:46:02Z

Job Description:

**Become a part of our caring community and help us put health first**

The Senior Provider Contracting Professional assists in negotiation, and execution of provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

**Job Functions:**

+ Partners closely with AZ, LA, and MS market engagement and leadership teams to support contract execution and drive towards growth goals

+ Partners and engages with legal team business partners to review and address contract term revisions

+ Ability to communicate contract terms, payment structures, and reimbursement rates to IPA and ACO provider(s) groups.

+ Analyzes financial impact of contracts and terms.

+ Maintains contracts and documentation within a tracking system.

+ Manages the relationship between the market payor partners and the PCO market leadership

+ Assists with new contracts and amendments with market payors due to changes in market needs or potential mergers and acquisitions.

+ Contract load and implementation with payor partners.

+ May assist with identifying and recruiting providers based on network composition and needs within the IPA/ACO markets.

+ Begins to influence departments strategy.

+ Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.

+ Exercises considerable latitude in determining objectives and approaches to assignments.

**Use your skills to make an impact**

**Required Qualifications**

+ Bachelor's degree or five years equivalent experience

+ A minimum of five years of progressive network management experience including hospital contracting and network administration in a healthcare company

+ Experience with Value Based Contracting

+ Managing and implementing care contracts with large physician groups, ancillary providers and hospital systems.

+ Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

+ Excellent written and verbal communication skills

+ Ability to manage multiple priorities in a fast-paced environment

+ Proficiency in MS Office applications

+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences

**Preferred Qualifications**

+ Experience with MSO

**Additional Information**

+ Travel to AZ, LA, MS Markets;

Apply Now!

Similar Jobs (0)