Network Contract Manager - Remote

About the role

As a Network Contract Manager within our network contracting team, you'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Manage unit cost budgets, target setting, performance reporting and associated financial models
• Guide development of the network and negotiate agreements with facility, physicians, and medical groups yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management and produces an affordable and predictable product for customers and business partners
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider specialties
• Provide explanations and information to others on difficult issues
• Work cross functionally to facilitate resolution of issues
• Position will support all contracting of primarily facility and physician providers for all lines of business

Required Qualifications

• 2+ years of experience in a network management-related role, such as contracting or provider services
• Proven knowledge of provider reimbursement methodologies
• Demonstrated in-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

Preferred Qualifications

• 2+ years of experience using financial models and analysis to negotiate rates with providers
• Intermediate level of knowledge of claims processing systems and guidelines
• Advanced competency of excel, including pivot tables
• Advanced competency of Microsoft Office Suite (Outlook, Word, PowerPoint) and SharePoint
• Demonstrated experience negotiating contracts with hospital, physician, and/or ancillary providers

Pay

The salary for this role will range from $72,800 - $130,000 annually based on full-time employment.