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The Senior Provider Contractor / Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. You will report to the Manager, Provider Contracting.
As the Senior Provider Contracting Professional you will:
- Communicate contract terms, payment structures, and reimbursement rates to providers.
- Analyze financial impact of contracts and terms.
- Maintain contracts and documentation within a tracking system.
- Help with identifying and recruiting providers based on network composition and needs.
- Use your skills to make an impact.
Required Qualifications
- 5 or more years of progressive network management experience including physician and/ or hospital contracting
- Experience in negotiating managed care contracts with large physician groups, ancillary providers and/or hospital systems
- Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers
Preferred Qualifications
- Bachelor's degree
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting
Additional Information
- Willing and able to travel up to 30% within the region with potential overnight stays
- Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
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