Manager, Contracting

» Manager, Contracting
Legal
in Bedford
, NH
Reference: 19-02946

Position Purpose:

  • Lead, negotiate, and manage multiple hospital, large medical group, physician, school and/or ancillary contracting activities in accordance with Corporate, health plan, and state guidelines
  • Oversee all activities of the contracting department
  • Develop and implement a network development plan for an assigned region and set of providers and identify and initiate contact with potential providers
  • Negotiate contracts with interested providers utilizing model provider agreements, and follow up on contracts
  • Lead negotiations, rate modeling, implementation and ongoing monitoring of assigned group of providers to maximize business relationships and opportunities
  • Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups
  • Evaluate and monitor providers’ performance standards and financial performance of contracts
  • Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language
  • Perform financial analyses to identify medical cost improvement opportunities and develop and execute contracting action plans to achieve results

Education/Experience:

  • Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field or equivalent experience
  • 4+ years of provider relations/contracting experience in a healthcare and/or managed care environment
  • Working knowledge of contracting language and the principles of negotiation
  • Familiarity with managed care, State and/or Federal health care programs
  • Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff

License/Certification:

  • Valid driver’s license