Manager, Network & Physician Contracting

Responsibilities

• Lead/support the development, negotiation, management, and maintenance of provider contracts.
• Work with the Director on fee-for-service (FFS) and value-based payment contracting initiatives.
• Collaborate with the payment evolution team to introduce updated payment models.
• Collaborate with the provider experience team to meet provider expectations.
• Lead/support complex negotiations and/or contracting arrangements.
• Develop a sound business strategy for financial and legal terms required for contracting initiatives.
• Work with Medical Economics and Actuary Department to draft provider rate proposals.
• Negotiate proposals with hospital executives, physicians, and ancillary providers directly.
• Manage the development and execution of the network contracting strategy.
• Avoid special arrangements and align to enterprise affordability objectives.
• Manage and negotiate contracts in compliance with Horizon reimbursement standards.
• Assist and implement provider contracting policies and procedures consistent with industry best practices and regulatory requirements.

Requirements

Hospital contracting experience strongly preferred.