Provider Contracting Professional 2

Profile

Description

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. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. 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. Follows established guidelines/procedures.

Required Qualifications


At least 5 years of experience in negotiating managed care contracts (Medicare preferred) with physicians 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 be passionate about contributing to an organization focused on continuously improving consumer experiences
Ability to travel 50% within the field (South Florida ; territory can be subject to change based on business need)
Medicare Risk Adjustment and HEDIS knowledge


Preferred Qualifications


Bachelor's or Master's Degree
Experience with ACO/Risk Contracting
Experience with Value Based Contracting


Additional Information


Office location is based in Doral, FL


Scheduled Weekly Hours

40

Company info

Sign Up Now - HealthcareCrossing.com