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Provider Network Manager Sr
4 weeks ago
Location: Topeka KS, Kansas City KS
Hours: M – F Standard Working Hours
Travel: Hybrid (1-2 days onsite per week) In state travel to clients as needed
Position Overview:
Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value-based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized.
How You Will Make an Impact:
Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development
Works independently and requires high level of judgment and discretion
May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management
May collaborate with sales team in making presentations to employer groups
Serves as a communication link between professional providers and the company
Ensure that network composition includes an appropriate distribution of provider specialties
Conducts more complex negotiations and drafts documents
Prepare financial projections and conduct analysis
Required Qualifications:
Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Experience in fee schedule development using actuarial models strongly preferred
Travels to worksite and other locations as necessary
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