Provider Network Manager
4 weeks ago
Location:
Des Moines, Iowa
Hours:
Standard M – F
Travel:
Hybrid role (1-2 days per week in office)
Position Overview:
Develops the provider network through contract negotiations (language and rates), relationship development, and servicing.
How You Will Make an Impact:
Contracting and negotiating contract terms
Typically works with less-complex to complex providers
Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required
Contracts may involve non-standard arrangements that require a moderate level of negotiation skills, Value based concepts understanding, Fee schedules can be customized
Works with increased independence and requires increased use of judgment and discretion
May work on cross-functional projects requiring collaboration with other key areas
Serves as a communication link between professional providers and the company
Conducts more complex negotiations and drafts documents
Assists in preparing financial projections and conducting analysis as required
Required Qualifications:
Requires a BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Medicaid or Medicare experience strongly preferred
Previous Healthcare Contract negotiation experience strongly preferred
Knowledge of Iowa Medicaid fee schedules preferred
Strong communications experience preferred
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