Network Contracts Manager
5 days ago
This is a highly rewarding role for an experienced professional to manage and support the administrative and operational aspects of our Provider Network Operations (PNO) Contracts Team.
We are seeking a skilled Contracts Specialist to perform contract negotiations, research, and analysis to close IPA network gaps and meet regulatory requirements. The ideal candidate will have a strong understanding of contracting principles and tools, with experience in legal/paralegal processes.
Main Responsibilities:
- Prepare, negotiate, and implement contracts and Letters of Agreement (LOAs) for physicians and ancillary providers in diverse areas for existing and developing client IPA networks
- Identify and resolve provider network adequacy and specialty needs for network growth
- Ensure contract compliance with DMHC, DHS, CMS, and other regulatory agencies
- Collaborate with the Contracts Supervisor and PNO leadership to meet departmental goals and requirements
- Evaluate and summarize problematic issues related to payer contracting
Requirements:
- Bachelor's degree in healthcare or related field preferred
- 4+ years Managed Care or Healthcare experience in Network Management or Contracting
- Knowledge of contracting principles and tools, experience in legal/paralegal process a plus
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