Talent.com
Network Contracting Specialist

Network Contracting Specialist

CurativeAustin, Texas
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters.remote
job_description.job_card.job_description

Duties And Responsibilities

  • Manages contract negotiations with physicians and physician groups in assigned area.
  • Conducting several negotiations simultaneously to meet growth demands.
  • Proactively builds relationships that nurture provider partnerships to support the local market strategy.
  • Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, Claims, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing.
  • Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position.
  • Identify and manage initiatives that improve total medical cost and quality.
  • Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
  • Assists in resolving elevated provider service complaints. Research problems and negotiate with internal / external partners / customers to resolve complex and / or escalated issues.
  • Manages key provider relationships and is accountable for critical interface with providers and business staff.
  • Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
  • Partner with Regulatory Affairs to ensure all network filings are timely and accurate.
  • Performs other duties as assigned

Position Requirements

  • Bachelor’s degree or equivalent experience in related field, plus 3+ years of work experience within provider contracting and / or health insurance
  • Experience with physician and physician group contracting and negotiations
  • Experience negotiating delegated credentialing agreements
  • Experience in developing and managing key provider relationships including senior executives
  • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners
  • Intimate understanding and experience with larger, more complex integrated delivery systems managed care, and provider business models
  • Team player with proven ability to develop strong working relationships within a fast-paced organization
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations
  • Customer centric and interpersonal skills are required
  • Superior problem solving, decision-making, negotiating skills, contract
  • language and financial acumen
  • Remote with occasional travel (5-10%)
  • Existing relationships with physicians and physician groups in Texas is highly recommended
  • serp_jobs.job_alerts.create_a_job

    Network Specialist • Austin, Texas