"Lighting a Path to the Future"

Manager, Provider Contracting-

Location: Bedford, NH
Job Type: Direct Hire
Degree: Bachelor;
Date: 2/14/2018
Job ID: 02567435
Job Description
Manager, Provider Contracting- Bedford, NH
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Fantastic leadership in this market – growing organization- integrated care model.

Lead, negotiate, and manage multiple hospital, large medical group, physician, school and/or ancillary contracting activities in accordance with Corporate, health plan, and state guidelines.
·  Oversee all activities of the contracting department
·  Develop and implement a network development plan for an assigned region and set of providers and identify and initiate contact with potential providers
·  Negotiate contracts with interested providers utilizing model provider agreements, and follow up on contracts
·  Lead negotiations, rate modeling, implementation and ongoing monitoring of assigned group of providers to maximize business relationships and opportunities
·  Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups
·  Evaluate and monitor providers’ performance standards and financial performance of contracts
·  Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language
·  Perform financial analyses to identify medical cost improvement opportunities and develop and execute contracting action plans to achieve results


Qualifications:

- Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field
-4+ years of provider relations/contracting experience in a healthcare and/or managed care environment.
-Working knowledge of contracting language and the principles of negotiation.
- Familiarity with managed care, State and/or Federal health care programs.
- Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

 




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