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Years of Experience
Date Last Verified
Provider Contract Specialist The candidate will report to the Manager, Provider Contracts. Will be responsible for supporting business people in local markets in negotiating contracts with hospitals, physician groups and other providers to participate in provider network, including taking a major role in reviewing, analyzing and drafting contract language as part of those negotiations. Will also support other legal matters related to provider relations, including assisting with disputes, provider manual support, provider communication review and other issues. Collaborate with Network representatives and in-house attorneys in various markets on all aspects of contracting with new and existing providers in networks across several states. Support strategic positioning for provider contacting, assist in development of contract templates and help identify opportunities for great value-orientation and new payment methodologies. Contribute to development of alternative networking initiatives and new provider business structures. Support attorneys and clients on provider relations issues. Perform other duties and work on projects as assigned.
Qualification and Experience
The candidate should preferably have a Bachelor's degree in a related field Business, Finance or Accounting. Should preferably also have paralegal certification/degree with contract specialization. Must have 5 years of experience in Front line provider contracting supporting a health plan, health insurance company or hospital/physician network in either business or legal department. Intermediate ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions is required. Advanced ability to analyze and interpret financial data in order to coordinate the preparation of financial records is needed. Intermediate knowledge of healthcare delivery is a must. Should have intermediate MS Excel, PowerPoint, Outlook, and Word skills.
Job Number: 1705935
Company infoHiring Coordinator