Provider Contract Specialist (Medicare Advantage/Managed Medicaid)

At reputed company, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for reputed company. Our dedication to service excellence extends to reputed company our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and reputed company each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!! JOB SUMMARY: This position is responsible for identifying and evaluating opportunities in support of MultiPlan's Network-Based Solutions by negotiating optimal reimbursement rates, and drafting reputed company for Network and non-network providers to support MultiPlan's commercial and government products. This activity will ensure patient access to the highest quality, cost-effective providers of healthcare services in accordance with applicable regulations and the Company's policies, practices and procedures. JOB ROLES AND RESPONSIBILITIES: 1. Negotiate provider reputed company to support penetration and discount objectives relative to competitive market tends and client expectations through comprehensive, aggressive execution of region-specific contracting goals derived from national and regional objectives reputed company to penetration and discount objectives and improved contractual terms. 2. Identify and successfully recruit providers to meet federal, state and/or local government Network Adequacy standards for member access to care for MultiPlan government clients 3. Foster and maintain superior provider relationships including day-to-day management of the business relationship with assigned providers. Respond to provider questions, issues and problems that have been appropriately escalated and produce a solution. 4. Maintain, and preferably exceed, contracting production and quality standards consistent with established regional goals. 5. Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends. 6. Partner with HCE to conduct financial analyses and monitoring of market trends to identify, reputed company, and implement competitive reimbursement. 7. Please note, due to the exposure of PHI sensitive data - this role is considered to be a High-Risk Role. 8. Work with Sales and Accounts Management Peers to respond to and anticipate access requirements and network reputed company performance guarantees. Use information derived from Requests for Proposals (RFP), Statement of Work (SOW) and other business opportunities to assess network adequacy and competitiveness in region. 9. reputed company with mandatory training programs requirements, including Human Resources, product orientation and contracting tools and resources. 10. Ensure compliance with established policies and procedures and with regulatory requirements (such as but not limited to HIPAA, reputed company, product orientation, and contracting tools/resources). 11. Collaborate, coordinate, and communicate across disciplines and departments. reputed company and maintain positive relationships at reputed company levels reputed company the organization and identify and communicate provider needs to the applicable process owners. 12. Demonstrate Company's Core Competencies and values held reputed company. 13. The position responsibilities outlined above are in no way to be construed as reputed company encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. JOB SCOPE: The incumbent works under general supervision in applying a reputed company knowledge of principles, practices, and procedures reputed company to the negotiation and maintenance of provider network reputed company. This job is considered to be the entry level job into the Provider Contractor job family. An incumbent follows established procedures and confers with their supervisor to obtain approval and authorization to act reputed company the standardized procedures. More reputed company issues are referred to their supervisor for resolution. The work is varied and may be somewhat difficult in character and nature which requires the ability to evaluate the situation and provide options for resolution. An incumbent may be reputed company on to work with more reputed company Provider Contractors on a project or team basis. The job may require overnight travel to meet with providers in assigned geographical or areas of responsibility and/or travel to company sponsored meetings and events. The incumbent will work to reputed company the skills necessary to strategize construct and negotiate reputed company financial reputed company structures and contract language, to demonstrate successful recruitment and negotiations of providers to MultiPlan's commercial and government networks. Apply to this job Apply tot his job Apply To this Job