Provider Network Negotiation Specialist

Role Description

To negotiate fee-for-service ancillary contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network.

• Negotiates fee-for-service home health and home infusion therapy, and other ancillary services; contracts for multiple lines of business in the managed care markets.
• Analyzes market data and financial models.
• Prepares, negotiates, and administers provider contracts.
• Develops and expands provider participation within the network.
• Maintains provider participation within the network.
• Monitors provider performance; implements corrective action plans.
• Identifies current issues and probable future issues; guides staff through resolution.
• Documents contracts; updates contracts as changes occur.
• Coordinates customer inquiries.

Qualifications

• Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred.
• Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required.
• Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred.
• Two (2) years supervisory experience preferred.
• Strong project management skills.
• Excellent negotiation skills.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Leadership/management/motivational skills.
• Analytical and interpretive skills.
• Strong organizational skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Benefits

• Three Medical, and two dental plans to choose from.
• Tuition reimbursement eligible.
• 401K plan that matches 50% on every $ you put in up to the first 6% you save.
• 4 weeks PTO your first full year.