Provider Contracting Professional

Role Overview

The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The role communicates contract terms, payment structures, and reimbursement rates to providers.

Responsibilities

• Analyzes financial impact of contracts and terms
• Maintains contracts and documentation within a tracking system
• May assist with identifying and recruiting providers based on network composition and needs
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Follows established guidelines/procedures

Required Qualifications

• Bachelor's degree
• 2–5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers
• Excellent written and verbal communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency in MS Office applications
• Must reside in Seminole, Orange, Osceola, Brevard

Preferred Qualifications

• Master's degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Pay

$65,000 – $88,600 per year, plus eligibility for a bonus incentive plan based upon company and/or individual performance.

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance

Schedule

40 hours per week. Travel 80% of the time (3–4 days a week).