Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Description
Provider Relations and Network Contracting develops the provider network through contract negotiations, relationship development, and servicing for affiliated physician groups. Primary focus of this role is identifying and recruiting providers based on network composition and needs. Deals with affiliated providers and drives and supports value base initiatives.
The role evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Physician providers and ensuring the network composition includes an appropriate distribution of providers.
Responsibilities
Required qualifications:
Job Type: Full-time
Pay: $60,000.00 - $75,000.00 per year
Benefits:
Schedule:
Ability to Relocate:
Work Location: In person