Description

In this role, you will manage contracts with healthcare providers to build and maintain a robust network, negotiate reimbursement rates, and support network growth. You'll analyze provider performance, ensure compliance with regulatory guidelines, and collaborate with cross-functional teams to optimize costs and member care.

Requirements

• 3+ years experience in healthcare client management, consulting, or provider contracting
• 2+ years experience supporting provider network strategy and negotiating contracts
• 1+ years experience running financial analyses on markets or product lines
• 1+ years experience navigating large data sets like claim files and provider rosters
• Associate's degree or equivalent preferred

Responsibilities

• Implement contracting strategies aligned with network adequacy and cost management objectives
• Manage and negotiate contracts with healthcare providers for favorable terms and compliance
• Conduct reviews and analyses of provider contracts to identify optimization opportunities
• Use data and analytics to inform negotiation and contracting decisions
• Monitor network compliance and develop corrective action plans