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Senior Medicare Contracts Analyst
4 months ago
We have an opportunity to join the Alliance as a
Senior Medicare Contracts Analyst, internally referenced as
Senior Provider Network Development Specialist
supporting the brand new team focused on recruitment and expansion of our provider network for the Provider Services Department.
This position has regular/ frequent in-community requirements within the Alliance service counties including Santa Cruz, San Benito, Mariposa, Merced, Monterey.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Provider Network Development Manager, this position:
Conducts and coordinates professional level healthcare provider recruitment efforts and related activities
Facilitates the onboarding process for new providers
Performs research and analysis related to provider network requirements, to develop provider recruitment strategies, and to identify opportunities for network expansion
Assists the Provider Network Development Manager with Unit administration and special projects
Performs other duties as assigned
ABOUT THE TEAM
From outreach and recruitment to educating and supporting our Provider Network, we're the team who establishes, builds, and maintains our positive working relationship with local providers.
THE IDEAL CANDIDATE
Experienced in professional healthcare provider recruitment and contracting across various specialties
Proficient in developing recruitment strategies and conducting outreach to new provider types, including non-traditional providers (mental health, doulas, etc.)
Skilled in negotiating contracts with a focus on high-quality care and cost-effectiveness
Capable of mentoring and coaching other specialists, serving as a subject matter expert
Proficient in conducting market research to identify network gaps and expansion opportunities
Able to analyze provider data and performance metrics to support network development strategies
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here .(update hyperlink prior to posting)
Knowledge of:
Thorough knowledge of the principles and practices of healthcare provider recruitment
Provider contract negotiation and contract management principles, including reimbursement rates, service level agreements, and performance metrics
Healthcare delivery systems, including hospitals, clinics, and other healthcare provider types
Health care industry and managed care concepts
Research, analysis, and reporting methods
Working knowledge of the California Medi-Cal program and related regulations
Ability to:
Act as a technical resource for Provider Network Development Specialists
Develop and implement effective provider recruitment strategies
Conduct provider outreach in a positive and professional manner that builds relationships and ability to take initiative to follow up with prospective providers as appropriate
Identify providers’ priorities and how the Alliance can meet providers’ needs
Education and Experience:
Bachelor’s degree in Healthcare Administration, Business Administration, Social Science, or a related field
Minimum of 5 years of experience in a managed care environment performing provider network development, provider relationsand/or provider contracting activities, which included a minimum of 3 years of experience performing provider recruitment activities and some experience working with Medi-Cal
Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying
OTHER INFORMATION
We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
The full compensation range for this position is listed by location below.
The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).
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