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Senior Network Contracting Specialist

2 months ago

Austin, Texas, United States Curative HR LLC Full time
Job Summary

We are seeking a highly skilled Senior Network Contracting Specialist to join our team at Curative HR LLC. This role will be responsible for managing contract negotiations with large physician groups and ancillary providers, ensuring that contract terms and conditions address the coding structures most impacted by negotiations.

Key Responsibilities
  • Manage contract negotiations with large physician groups and ancillary providers to meet growth demands
  • Develop and maintain effective relationships with matrix partners, including Claims, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales, and Marketing
  • Identify and manage initiatives that improve total medical cost and quality, including renegotiation of existing agreements
  • Prepare, analyze, review, and project financial impact of high-spend or increasingly complex provider contracts and alternate contract terms
  • Collaborate cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and review analysis of reports as part of negotiation and reimbursement modeling activities
  • Assist in resolving elevated provider service complaints, researching and negotiating with internal/external partners/customers to resolve complex and/or escalated issues
Requirements
  • Bachelor's degree or equivalent experience in a related field, including 7+ years of work experience beyond degree within provider contracting and/or health insurance
  • 7+ years of experience with health plan or provider organizations
  • Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen
  • Experience with Physician group and ancillary provider contracting and negotiations
  • Experience negotiating delegated credentialing agreements
  • Experience in developing and managing key provider relationships, including senior executives
  • Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners
  • Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models
  • Team player with proven ability to develop strong working relationships within a fast-paced organization
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills