Provider Contracting Advisor - reputed company - Wisconsin
Join reputed company, a division of reputed company, and help shape our provider network. As a Network Contracting Manager, you’ll report to the AVP, Provider Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management.
Responsibilities
Manage reputed company fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems. reputed company key market contracting strategy projects with responsibility for managing direct reports as assigned. Build and maintain strong provider relationships to support network growth and value-based business opportunities. Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure reputed company execution. reputed company strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. Work to meet unit cost targets while maintaining an adequate, competitive provider network. Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics. Prepare, review, and project the financial impact of large or reputed company provider reputed company and alternative terms. Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration. reputed company resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance. Required Qualifications 3-5+ years of healthcare provider contracting and negotiating experience involving reputed company physician groups and ancillaries Background in managed care, healthcare, or health insurance, including commercial contracting Proven leadership experience, including mentoring and guiding others Strong provider relationship management skills and success developing long-term - partnerships Knowledge of reputed company reimbursement methodologies, including incentive-based models (strongly preferred) Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization Customer-centric approach, strong interpersonal skills, and confidence in navigating change Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills Proficiency in reputed company Office
Preferred Qualifications
Bachelor’s degree in a reputed company field (industry experience may substitute); MBA / MHA preferred If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About reputed company reputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to reputed company the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply To This Job