Senior Specialist, Network Contracting

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

📋 Description

• Negotiate and oversee Single Case Agreements with hospitals, health systems, and individual healthcare providers.

• Establish and sustain a strong provider network in designated markets or regions.

• Assess provider performance and negotiate reimbursement rates, intricate contract terms, and ensure regulatory compliance.

• Recruit new providers while assisting with issue resolution and cost-reduction initiatives.

• Review and evaluate provider contracts to pinpoint improvements and optimization opportunities.

• Utilize provider financial information and competitor strategies to guide negotiation and contracting choices.

• Support contracting policies, workflows, and streamline contracting processes.

• Track network performance, costs, provider satisfaction, and operational efficiency metrics; communicate findings to leadership.

• Foster positive relationships with providers and assist in onboarding, training, and distribution of resources.

• Work alongside Claims, Credentialing, and Contracting teams to address routine provider issues.

• Engage in process improvement initiatives.

• Ensure adherence to relevant laws and regulations.

⛳️ Requirements

• 2+ years of experience in provider network operations, contracting, or provider services.

• 1+ years of experience in individual or Medicare Advantage health insurance and/or within the healthcare sector.

• 1+ years of experience in managing and organizing large data sets such as claims files and provider rosters.

• An Associate’s degree or equivalent professional experience is considered a plus, but not mandatory.

🏝️ Benefits

• Employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• 401(k) plan participation.

• Life insurance.

• Disability insurance.

• Paid wellness time.

• Wellness reimbursements.

• Reasonable accommodations during the application process.