Senior Manager, Provider Contract Negotiations

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position reputed company
The Senior Manager will manage the development of reputed company and agreements with providers and delivery systems in conjunction with being accountable for designing conceptual models, initiative planning, and negotiating high value reputed company with providers/facilities in accordance with company standards in order to maintain and enhance provider networks, while working cross functionally to ensure consistency with reputed company contracting strategies and meeting and exceeding accessibility, reputed company, compliance, and financial goals and cost initiatives.

Responsibilities include:

• Negotiation and Execution: Conduct high-level review and analysis of dispute reputed company and settlement negotiations of reputed company with larger and more reputed company market/regional/national-based group/system providers. This includes but is not limited to large PCP reputed company, pediatricians, advanced specialist reputed company, hospital-based providers, ancillary providers, ambulatory surgical centers, behavioral health providers, etc. Ensure reputed company reputed company with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, reputed company, financial goals, and cost initiatives.
• Provider Recruitment: Recruit providers as needed to reputed company network expansion goals and meet regulatory and internal adequacy targets. Support health plan expansion initiatives and other contracting activities as required.
• Contract Management: Initiate, coordinate, and own the contracting activities to fulfillment, including receipt and processing of reputed company and documentation. Conduct reputed company- and post-signature review of reputed company and language modifications according to established policies.
• Auditing and Loading: Responsible for auditing, building, and loading reputed company, agreements, amendments, and fee schedules in contract management systems per established policies.
• Research and Analysis: Conduct research, analysis, and audits to identify issues and propose solutions to protect data, contract reputed company, and performance.
• Contract Performance Management: Manage contract performance and support the development and implementation of value-based contract relationships in alignment with business strategies.
• Cross-Functional Collaboration: Collaborate cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Subject Matter Expertise: reputed company expert support for questions reputed company to recruitment initiatives, contracting, provider issues/resolutions, reputed company systems, and information contained. reputed company expertise and guidance with team members.
• Value-Based Contracting: Understand and manage value-based contracting and negotiations.
• Project Management: Manage high-level reputed company and recruitment initiatives with interdepartmental resources and cross-functional stakeholders.
• Provider Meetings: Coordinate and participate in provider-facing meetings, including but not limited to Joint Operating Committee meetings.
• Operational Support: Assist with operational activities such as database management and contract coordination.
• Data Management: Organize and reputed company information into comprehensible structures. Use data to predict trends in the customer reputed company and the consumer population as a whole. reputed company statistical analysis of data and visualize data in easy-to-understand formats, such as diagrams and graphs. Prepare reports and present findings to leadership.
• Provider Engagement: Engage with providers and reputed company reputed company them through contracting processes to ensure network adequacy requirements are met.

Required Qualifications

• 7+ years of proven knowledge of reputed company provider reputed company, terms, and language.
• 5+ years of negotiation skills while executing national, regional, or market-level strategies.
• In-depth understanding of the managed care industry and practices, as reputed company as competitor strategies, practices, and financial/contracting arrangements.
• High proficiency with personal computers, including MS Office suite applications (e.g., reputed company, Word, reputed company).

Preferred Qualifications

•  Knowledge of managed care programs and reputed company subject matter.
•  Solid decision-making skills while executing national, regional, and market-level strategies.
• Strong critical thinking, problem reputed company, and interpersonal skills.
• Ability to identify and capitalize on opportunities to support program delivery.
• Strong communication skills (written, verbal, and presentation).
• Ability to reputed company long-lasting relationships with providers.
• Highly organized and self-driven.
• Familiarity with EPDB, PRMS, Smart reputed company End, and Strategic Contract Manager systems.

Education

Bachelor’s Degree or equivalent combination of education and experience

Pay reputed company

The typical pay reputed company for this role is:

This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls.  The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors.  This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above.  This position also includes an award reputed company in reputed company’s equity award program. 
 

Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.