Contract Negotiation Manager

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Evaluates, analyzes, negotiates, and finalizes Medicaid contracts.

• Oversees reimbursement dispute resolution and settlement negotiations with provider groups for the Medicaid sector.

• Executes all tasks related to the standard intake and implementation of contracts.

• Manages contract performance to support network quality, availability, and financial objectives and strategies.

• Recruits providers as necessary to ensure the achievement of network expansion and adequacy goals.

• Collaborates across functions to aid in the development of provider compensation and pricing strategies, the submission of contractual information, and the analysis of reports as part of negotiation and reimbursement modeling efforts.

• Responsible for identifying cost management issues and providing recommendations to support cost-saving initiatives and/or settlement processes.

• Implements network development, maintenance, and refinement strategies as needed.

• Offers contract expertise and assistance to other internal business partners or units concerning contract setup accuracy, language interpretation, claims payment, and other issues requiring network contracting knowledge.

• Leads and/or engages in special projects.

⛳️ Requirements

• 3-5 years of experience in provider contract negotiations or provider relations.

• Demonstrated knowledge of the Medicaid service line, preferably within the Kentucky program.

• Must reside in the state of Kentucky.

• Expertise in Medicaid provider relations or claims payment (preferred).

• Strong and proficient skills in negotiating managed care networks.

• Excellent communication, critical thinking, problem-solving, and interpersonal abilities.

• Skilled in execution and delivery (planning, executing, and supporting) tasks.

• Proficient in business intelligence.

• Effective in collaboration and teamwork.

• Possesses a growth mindset (agility and the ability to develop oneself and others).

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources based on eligibility.