Provider Relations Specialist
3 weeks ago
Position: Senior Provider Contracting Specialist
Role Overview:
This advanced-level position is pivotal in establishing and nurturing strategic, creative, and data-driven partnerships with healthcare providers. The specialist will work autonomously to drive performance improvements, negotiate high-stake contracts, and maintain robust relationships with various healthcare stakeholders.
Key Responsibilities:
- Strategic Partnership Development: Foster a trusted environment with providers through relationship management, leveraging data to identify and act on collaboration opportunities that enhance performance metrics.
- Contract Negotiation and Management: Conduct evaluations and negotiations compliant with company standards and controls. Ensure contracts support value-based care objectives, focusing on risk-based agreements with integrated quality and cost measures.
- Relationship Maintenance: Sustain and deepen relationships with Hospital, Physician, Pharmacy, and Ancillary providers, ensuring a balanced network. Regularly engage with contracting peers and leaders to enhance collaboration and mutual benefits.
- Expertise and Advocacy: Serve as a subject matter expert on provider value-based programs, facilitating understanding and participation in the network. Develop solutions with cross-functional teams to optimize provider performance.
Qualifications:
- Bachelor’s degree or equivalent in a related field.
- 3+ years of post-degree experience in provider contracting, including expertise in value-based and total-cost-of-care arrangements.
- Strong understanding of ACOs and various contracting methodologies.
Skills and Abilities:
- Proven ability to negotiate and maintain significant provider contracts.
- Exceptional relationship-building and maintenance skills across all organizational levels, including senior leadership.
- Strong financial, analytical, and problem-solving skills.
- Excellent communication abilities, both written and verbal, capable of conveying complex information clearly and persuasively.
- Experience in contract interpretation, provider value-based financial analysis, and legal aspects of contracting.
- Demonstrated competency in managing projects to meet deadlines and organizational goals.
- Ability to facilitate information sharing and drive discussions within clinically integrated network teams.
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