Managed Care Contracting Manager
3 weeks ago
People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.
We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.
We are looking for a Network Contracting Manager. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Henderson, NV, then you should consider joining our team. P3 is headquartered in Nevada with additional offices in OR, CA, AZ and FL.
Network Contracting Manager
Overall Purpose:
The Network Contracting Manager is responsible for developing, negotiating, and managing contractual, legal and financial arrangements with providers that ensure our patients have superior access to the highest quality, cost-effective providers of healthcare services.
Education and Experience:
* Bachelor's Degree preferred or in process of completion or equivalent experience.
* Must have a minimum of five years of specific work experience in managed care contracting to include network expansion projects, hospital contracting, primary and specialty physician contracting, and ancillary contracting.
* Must be well versed in CMS reimbursement methodologies, including capitation, per visit, per diem, DRG, APC, and value-based incentives.
* Robust understanding of Medicare Advantage is highly preferred.
* Prefer national contracting negotiation experience.
* Prefer network operations experience.
Knowledge, Skills and Abilities:
* Must have a high level of interpersonal skills to handle sensitive and confidential situations. Position continually requires demonstrated poise, tact and diplomacy.
* Excellent verbal and written skills.
* Ability to interact and communicate with individuals at all levels of the organization and external parties.
* Demonstrated knowledge of variety of computer software applications in word processing, spreadsheets, database, and presentation software (Word, Excel, Access, PowerPoint)
* Work requires continual attention to detail in composing, typing and proofing contracts.
* Demonstrated ability to create applicable contract language and have taken college level courses in writing contracts.
* Ability to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks and demands.
* Excellent planning and coordinating skills.
* Ability to travel. Travel will be required to engage with potential providers, develop relationships with physicians, clinical teams, etc. and overall building of the organization's networks. Travel may include local daytime to the market or may also be overnight travel as assigned.
Essential Functions:
* Assist with all network contracting activities, including physician, ancillary and hospital contracting.
* Support Network Development & Contracting with payer negotiations and implementations.
* Participate in all new network expansions and future organizational opportunities.
* Acts as a liaison for various contracting and operational projects for hospitals, ancillary providers, and physicians.
* Coordinates managed care contracting for acquisitions and networks.
* Coordinates and produces Monthly Network Contracting Reports.
* Oversees variety of Network Contracting processes.
* Applies approaches and methodologies to accomplish project deliverables, such as analysis, documentation, and training.
* Handles confidential and non-routine information.
* Delivers assigned projects on time and compliant to applicable state and federal regulations. Assure project milestones and deliverables are met.
* Must have car and ability to travel overnight.
* Organizes and prioritizes large volumes of information.
* General administrative duties.
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