Network Contract Manager Job Description
Network contract manager
provides health system leadership in the areas of population health, ambulatory quality / utilization, PCMH, and "value" based care.
Network Contract Manager Duties & Responsibilities
To write an effective network contract manager job description, begin by listing detailed duties, responsibilities and expectations. We have included network contract manager job description templates that you can modify and use.
Sample responsibilities for this position include:
Oversee the identification, collection, and manipulation of data within multiple contract modeling tools, billing systems, and databases (e.g., Payment Integrity Compass, EPSI, EPIC) and external sources (e.g., Medicare/Medicaid websites)
Lead and support cross-functional teams to resource information, make strategic recommendations to create and execute compelling and comprehensive business cases
Develop the provider network (hospitals, ancillary groups & facilities, physicians, ) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners
Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
Establish and maintain strong business relationships with Hospital, Physician or Ancillary providers, and ensure the network composition includes an appropriate distribution of provider specialties
Applicant should have an attention for detail, excel in prioritizing and handling multiple tasks, and be prepared to go above and beyond what is listed in this posting
Convey complex or technical information in a manner that others can understand, demonstrate the ability to understand and interpret complex information form others
Will support the Indiana Health Plan
You will be part of a team of 6 Physician Contractors
This position establishes and maintains strong business relationships with Physicians both telephonically and face to face to increase and maintain Net Promoter Score
Network Contract Manager Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Network Contract Manager
List any licenses or certifications required by the position: PMP, ITIL
Education for Network Contract Manager
Typically a job would require a certain level of education.
Employers hiring for the network contract manager job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Education, Business/Administration, Management, Finance, Graduate, Business, Engineering, Health Care, Healthcare, Health Care Administration
Skills for Network Contract Manager
Desired skills for network contract manager include:
Claims processing systems and guidelines
Medicare Resource Based Relative Value System
Medicare reimbursement methodologies
Resource Based Relative Value System
Ambulatory Surgery Center Groupers
DRGs
Medicare
APCs
Per-diem
Desired experience for network contract manager includes:
Excellent analytical skills, with extensive modeling experience and ability to perform key performance indicator trend analysis
In-depth knowledge of managed care reimbursement methodologies, including DRG, APC and Resource Based Relative Value System (RBRVS)
Center Groupers
4+ years working with Medicare reimbursement methodologies, Resource Based Relative Value System (RBRVS)
Undergraduate degree or equivalent related work experience
2+ years in a role demonstrating strong negotiation skills
Network Contract Manager Examples
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Network Contract Manager Job Description
Job Description Example
Our growing company is searching for experienced candidates for the position of network contract manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for network contract manager
- Maintain an ongoing knowledge of provider’s business
- Lead contract negotiations for both hospitals and medical groups
- Contract implementation coordination
- Service for the Inland Empire (San Bernardino and Riverside), working with providers on resolving contract related issues
- Independently develop contract negotiation strategies with providers to meet all business objectives
- Audit provider data across multiple platforms and submit requests to update data as needed
- Lead contract negotiations for hospitals and medical groups in the Inland Empire
- Collaborate with other departments within UHC to achieve favorable negotiation outcomes (finance, pricing, legal)
- Cultivate relationships and partnerships with assigned providers in the Inland Empire
- Serve as the primary point of contact for all medical groups and hospitals
Qualifications for network contract manager
- Contracting experience in South Florida Market
- Some local travel (Chicagoland and Northwest Indiana) to provider sites and committee meetings will be required
- 4+ years experience in a network management-related role, such as contracting or network development
- Intermediate knowledge of Medicare reimbursement methodologies, Resource Based Relative Value System (RBRVS)
- Working knowledge of Medicare reimbursement methodologies, Resource Based Relative Value System (RBRVS)
- Experience with Medicare reimbursement methodologies, Resource Based Relative Value System (RBRVS)
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Network Contract Manager Job Description
Job Description Example
Our growing company is hiring for a network contract manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for network contract manager
- Manages contract negotiation and change order process with minimal support through close-out and warranty completion
- Provides recommendation to project on best practices for scope security and risk assessment
- Assists in escalated issue resolution items through the warranty stage of the contract lifecycle
- Read, understand and draft Prime contract flow downs
- Complete or assist in the development of project contract templates
- Understand and report on the procurement project deliverables to include man-hours, client reports, and monthly operations reports
- Participate and have the ability to lead Procurement Status meetings
- Monitor and support activities of Contract Specialists I and II on assigned projects
- Understands project cost data, buyout log and business management interdependencies
- Participate in internal project presentations
Qualifications for network contract manager
- Excellent verbal and written communication skills with the ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, ability to understand and interpret complex information form others, including but not limited to reimbursement policy standards
- 4+ year’s experience in a network management-related role, such as contracting or provider service
- Experience with Quality Driven Contracts both from administration negotiation standpoint
- Proficiency in Medicare reimbursement methodologies, Resource Based Relative Value System (RBRVS)
- Excellent verbal and written communication skills(ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, ability to understand and interpret complex information from others)
- Extensive knowledge and use of Facets Software
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Network Contract Manager Job Description
Job Description Example
Our company is growing rapidly and is looking for a network contract manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for network contract manager
- Responsible for negotiation of individual provider contracts with goal of managing to our “standard template terms”
- Work independently, as we're telecommuters
- Build and maintain strong relationships with Providers in the market
- Coordinates the management and growth of the hospital relations program or ancillary networks
- Monitors team activities to assure that staff meets performance standards and is operating effectively and efficiently
- Coordinates provider network related activities in conjunction with the appropriate home office and local health plan staff
- Develops and implements provider agreements
- Negotiates contracts with providers statewide
- Manages provider relations issue resolution, education/orientation, evaluation of network adequacy, recruitment and marketing related to providers
- Hires, trains, coaches, counsels, and evaluations the performance of direct reports
Qualifications for network contract manager
- Ability to provide both hands on solutions and keep on top of projects deliver training
- 3+ years of experience in healthcare network contract management (ideally in pharmaceutical contracts handling complex rebate and procurement agreements with accountability for business results), or equivalent experience
- Retail pharmacy or Pharmacy Benefit Management knowledge
- 2+ years of experience in contract negotiations, specifically with hospitals and medical groups
- Proficiency with MS OneNote, PowerPoint
- 2+ years of experience in complex contract negotiations, specifically with hospitals and medical groups
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Network Contract Manager Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of network contract manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for network contract manager
- Analyze terms of new and existing contract language, reimbursement methodologies and payer policies and protocols
- To assist Head of Network Services and Program Director for formulation of Network Services strategic plan
- Lead and manage regional or large-scale network projects or programs
- Maintain and refine the project life cycle processes including business case, project initiation, project approval, stakeholder communication and implementation
- Liaise and ensure effective communication across the organizations and key stakeholders in aligning expectation and project/resource/budget/timeframe prioritization
- Monitor and control project progress and provide regular reports including time, cost, risk, scope and benefits
- Identify risks and provide mitigation plan which aligned with project goals
- Manage Network staff
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls with focus on ancillary and physician provider types, including but not limited to free standing centers such as ambulatory surgery centers, urgent care centers, rehabilitation centers, radiology centers, and birthing centers and their affiliated facility-based physician groups
- Perform conceptual analyses
Qualifications for network contract manager
- Ability to utilize financial models and analysis in negotiating rates and reimbursement methodologies with providers
- Access to reliable transportation and ability to travel 90% when expanding new markets
- 3+ years of experience in performing network adequacy analysis Excellent verbal and written communication skills
- Knowledge of Contract Specialist II responsibilities
- Undergraduate degree or work equivalent experience
- At least an intermediate knowledge of Medicare reimbursement methodologies, Resource Based Relative Value System (RBRVS)
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Network Contract Manager Job Description
Job Description Example
Our growing company is looking to fill the role of network contract manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for network contract manager
- This role is all about challenge and relationships
- Manage day-to-day project activities and related meetings
- Manage vendor relationships in multiple countries across Asia as the project develops
- Identify and remove impediments and facilitate discussion and conflict resolution
- Manage project scope, deliverables, issues, risks and dependencies across various functional teams to support a highly collaborative work environment
- Work with stakeholders and manage expectations
- Create project schedules using industry standard methodologies
- Identify and submit change requests for approval
- Capture and report project status, issues, risks and dependencies and ensure the project management information systems are maintained with accurate and current information
- Complete risk planning activities to mitigate and/or eliminate them
Qualifications for network contract manager
- Experience in performing network adequacy analysis preferred
- Hospital and ancillary experience preferred
- Live within commutable distance of the location listed for this specific career opportunity
- Must be highly motivated individual with excellent organizational skills to manage large volumes of information and multiple assignments
- Must be able to conceptualize and envision the impact of change and seek out efficiencies at work
- Leadership and supervisory skills to help coach and develop staff