Associate, Network Contracting (Northeast Region)
About the role
About the role
Work Location
Pay Transparency
Responsibilities
- Implement contracting strategies under the direction of Network Director and/or Senior Manager 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.
- Meet 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.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
- 2+ years of experience supporting provider network strategy development and negotiating provider contracts
- 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities
- 1+ years experience navigating and organizing large data sets such as claim files and provider rosters
Bonus points
- Associate's degree or equivalent professional working experience
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Artificial Intelligence (AI)
Reasonable Accommodation
California Residents
Not included in the source posting: about the role, benefits.
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