Manager, Network Relations

This is a fully remote position, open to applicants in Idaho, +2 more states.

📋 Description

• Negotiates, executes, reviews, and analyzes contracts, as well as manages dispute resolution and settlement negotiations with individual, small group, or local providers.

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

• Recruits providers as necessary to achieve network expansion and adequacy goals.

• Works collaboratively across functions to aid in the development of provider compensation and pricing recommendations.

• Identifies and suggests solutions for managing cost issues and supports initiatives aimed at cost reduction.

• Provides strategies for network development, maintenance, and enhancement in alignment with the cross-market network management unit.

• Assists in the design, development, management, and/or execution of strategic network configurations and integration activities.

• Enhances interactions with assigned providers and internal business partners to foster strong relationships.

• Ensures the resolution of escalated issues related to claims payment, contract interpretation, and the accuracy of provider contract or demographic data.

⛳️ Requirements

• A minimum of 5 years of experience in negotiating contracts with ancillary providers, facilities, and physician groups.

• Proficient in contract language development, rate proposal analysis, and identifying operational and financial improvement opportunities.

• At least 3 years of experience in provider relationship management or related roles within healthcare.

• Familiarity with common contract provisions, provider reimbursement methodologies and terms, as well as industry-standard payment policies and practices.

• Knowledge of provider financial challenges, regulatory mandates, and competitor strategies.

• Competence in using Microsoft Office suite applications (e.g., Outlook, Word, Excel).

• Ability to cultivate collaborative relationships with providers and work across various functions to address complex contract issues.

• Highly organized, capable of managing and prioritizing multiple negotiations and tasks to meet deadlines.

• Bachelor’s degree or a combination of relevant professional experience and education.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources, based on eligibility.