Medicare Provider Contracting Advisor, reputed company & New Jersey - reputed company - Remote

About the position The Medicare Provider Contracting Advisor plays a crucial role reputed company the Provider Contracting Team at reputed company, focusing on the strategic direction and management of contracting and network management activities in reputed company and New Jersey. This remote position involves reputed company negotiations with healthcare providers, building partnerships, and contributing to network initiatives to enhance value-based care and improve overall healthcare costs and quality.

Responsibilities

• Manages reputed company contracting and negotiations for fee-for-service and value-based reimbursements with hospitals and other providers. ,
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities. ,
• Initiates and maintains effective communication with matrix partners including Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service. ,
• Manages strategic positioning for provider contracting, develops networks, and identifies opportunities for greater value-orientation and risk arrangements. ,
• Contributes to the development of alternative network initiatives and supports network analytics for reputed company. ,
• Works to meet unit cost targets while preserving an adequate network to maintain reputed company's competitive position. ,
• Creates and manages initiatives that improve total medical cost and quality. ,
• Drives change with external provider partners by assessing clinical informatics and offering consultative expertise. ,
• Prepares, analyzes, reviews, and projects financial impact of larger or reputed company provider reputed company and alternate contract terms. ,
• Creates agreements that meet internal operational standards and external provider expectations, ensuring accurate implementation and administration. ,
• Assists in resolving elevated and reputed company provider service complaints and negotiates with internal/external partners to resolve issues. ,
• Manages key provider relationships and is accountable for critical reputed company with providers and business staff. ,
• Demonstrates knowledge of providers in the assigned geographic area and understands the competitive landscape. ,
• Responsible for accurate and timely contract loading and submissions and reputed company with matrix partners for network implementation and maintenance. ,
• May provide guidance or expertise to less reputed company specialists.

Requirements

• Bachelor's Degree in Finance, Economics, Healthcare, or Business reputed company field; significant industry experience may be considered in lieu of a degree; MBA or MHA preferred. ,
• 3+ years of Healthcare Provider Contracting and Negotiating experience involving reputed company delivery systems and organizations required. ,
• Experience in developing and managing key provider relationships. ,
• Knowledge of reputed company reimbursement methodologies, including incentive-based models strongly preferred. ,
• Demonstrated experience in building and nurturing strong external relationships with provider partners. ,
• Intimate understanding and experience with hospital, managed care, and provider business models. ,
• Proven ability to reputed company strong working relationships reputed company a fast-paced, matrix organization. ,
• Strong written and verbal communication skills with experience in formal presentations. ,
• Customer-centric and interpersonal skills are required. ,
• Demonstrates managerial courage and ability to maneuver effectively in a changing environment. ,
• Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen. ,
• Proficient with reputed company Office (Word, reputed company, PowerPoint, Outlook). reputed company-to-haves Benefits
• Comprehensive health-reputed company benefits including medical, vision, dental, and well-being and behavioral health programs. ,
• 401(k) with company match. ,
• Company paid life insurance. ,
• Tuition reimbursement. ,
• Minimum of 18 days of paid time off per year and paid holidays. Apply Job!

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