Job Details

Overview

Provider Network Contract Negotiator (Hybrid/Remote Option-NC)

Primary Purpose of Position: This position will assist the Provider Network Contract Manager in identifying, negotiating, and contracting with Medicaid healthcare providers to join Partners health plan network. This position will be responsible for drafting, implementing, and monitoring of all provider contracts, ensuring all financial requirements and obligations are accurately identified and executed.

Office Location: Hybrid/Remote option; Available for any of Partners' NC locations

Closing Date: Open Until Filled

Compensation and Benefits

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer

Note: See attachment for additional details.

Primary Responsibilities

• Perform healthcare provider contracting services.
• Lead recruitment and contracting efforts with targeted providers to initiate, negotiate, and procure executed participating provider agreements.
• Lead all aspects of negotiations for facility, physician and network managed care agreements under supervision.
• Coordinate, analyze and develop financial and operational aspects of contract proposals, including drafting and redlining agreements and amendments.
• Collaborate with Contracts Managers and the Contracting Director to develop negotiation strategies and assess party strengths.
• Coordinate with internal departments and contracted providers to implement and maintain contract compliance.
• Prepare correspondence to managed care providers.
• Work with Contract Coordinators to ensure workflow and contract management processes, including loading into contract management system and preparing summaries for internal stakeholders.
• Establish and maintain relationships with providers and support them through the Provider Relations team.
• Answer contractual questions and facilitate issue resolution with internal and external stakeholders.
• Assist with development and maintenance of reports used to track contracting activity and outcomes.
• Performs other duties as assigned.

Knowledge, Skills and Abilities

• Considerable knowledge of state and federal fiscal rules and regulations
• Knowledge of and ability to explain and apply provisions of contractual practices adopted by State Government
• Strong problem solving, decision-making and negotiating skills
• Strong written and verbal communication skills
• Excellent organizational skills
• Ability to multi-task and meet deadlines
• Considerable knowledge of the laws, regulations and policies that govern the program
• Exceptional interpersonal and communication skills
• Strong problem solving, negotiation, arbitration, and conflict resolution skills
• Excellent computer skills and proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint)
• Ability to verify documents for accuracy and completeness; apply laws, rules and regulations to various situations; and maintain consumer medical records, personnel records, and facility licensure requirements
• Ability to make prompt independent decisions based on relevant facts
• Ability to establish rapport and maintain effective working relationships
• Ability to act with tact and diplomacy in all situations
• Ability to maintain strict confidentiality in all areas of work

Education and Experience

Education and Experience Required: Bachelors Degree and four years of negotiation experience in managed care or a related field (such as healthcare finance or patient financial services) with a healthcare provider or insurer/payer, auditing, accounting, finance, or contract management; or an equivalent combination of education and experience. A combination of relevant experience may be considered in lieu of a Bachelors degree.

Must have ability to travel as indicated.

Must reside in North Carolina or within 40 miles of the NC border.

Education and Experience Preferred

Familiarity with State health care programs preferred.

Seniority level

• Mid-Senior level

Employment type

• Contract

Job function

• Legal

Industries

• Hospitals and Health Care