Manager, Network Contracting (Georgia)

Responsibilities

• Implement contracting strategies under the direction of Network Lead and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
• Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
• Maintain team performance for defined metrics and SLAs including but not limited to provider outreach and contract completion.
• Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
• Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies.

Requirements

• 6+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management.
• 4+ years of experience managing complex Provider Network strategies and negotiating complex contracts.
• 3+ years experience in Health Insurance (Individual and/or ACA Market Place) and/or Healthcare industry.
• Bachelor's degree or equivalent professional working experience.
• 3+ years of leadership experience.

Qualifications

You are also eligible for employee benefits, unlimited PTO, and annual performance bonuses.

Skills

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Benefits

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.