Description:
- Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with corporate, health plan and state guidelines
- Ensure that all necessary documentation and information are included
Responsibilities:
- Recruit and develop network for a region and set of providers
- Lead assigned recruitments (i.e., physician, hospital and ancillary) and ensure they result in complete and accurate standard contracts that meet objectives
- Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication
- Initiate contact and identify potential providers by geographic and specialty needs and update database
- Coordinate with internal departments and contracted providers to implement and maintain contract compliance
Education/Experience:
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, related field or equivalent experience
- 0-2 years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician’s office or group setting
- Familiarity with State and/or federal health care programs preferred (Medicaid, Medicare)