Description:
Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi specialty groups) and ancillary service agreements that are in accordance with corporate, health plan and state guidelines.
Responsibilities:
- Oversee all negotiations for a specific plan or provider type (large professional groups, hospitals, etc.)
- Assist with plan specific contracting strategy
- Manage delivery of financial settlements and collections of receivables
- Evaluate and monitor providers’ performance standards and financial performance of contracts
- Develop contracting action plans
- Coordinate with internal departments and contracted providers to implement and maintain contract compliance
Education/Experience:
- Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field or equivalent experience
- 4+ years of contracting or provider relations experience in a healthcare, managed care, or insurance related environment
License/Certifications:
- Current RN License (strongly preferred)