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Manager, Provider Contracting

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Job Summary
Manager, Provider Contracting- Bedford, NH-Fantastic leadership in this market – growing organization- integrated care model.-Lead, negotiate, and manage multiple hospital, large medical group, physician, school and/or ancillary contracting activities in accordance with Corporate, health plan, and state guidelines. -Oversee all activities of the contracting department -Develop and implement a network development plan for an assigned region and set of providers and identify and initiate contact with potential providers -Negotiate contracts with interested providers utilizing model provider agreements, and follow up on contracts-Lead negotiations, rate modeling, implementation and ongoing monitoring of assigned group of providers to maximize business relationships and opportunities -Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups -Evaluate and monitor providers’ performance standards and financial performance of contracts -Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language -Perform financial analyses to identify medical cost improvement opportunities and develop and execute contracting action plans to achieve results
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Job Requirement
- Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field
-4+ years of provider relations/contracting experience in a healthcare and/or managed care environment.
-Working knowledge of contracting language and the principles of negotiation.
- Familiarity with managed care, State and/or Federal health care programs.
- Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
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