The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Provider Contracting Professional negotiates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. Identifies and recruits providers based on network composition and needs. Helps to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
- Bachelor’s degree
- 3 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
- Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems.
- 1-2 years of experience working with Ohio Medicaid with understanding of Ohio Medicaid compliance
- Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
- Excellent written and verbal communication skills
- Ability to manage multiple priorities in a fast-paced environment
- Proficiency in MS Office applications
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Master’s Degree
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting
This position is considered “remote/work at home”, however, you must live within the State of Ohio to be considered for this opportunity.
Scheduled Weekly Hours