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The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.
The Provider Contracting Executive is responsible for value based contracting for complex provider systems and negotiates incentive based compensation to motivate provider performance. This position is also responsible for a geographic network, insuring the highest quality of providers available for our members and engaged providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
4 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
8+ years of healthcare industry experience
Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development
Excellent written and verbal communication skills and experience presenting to varied audiences
Ability to manage multiple priorities in a fast-paced environment
Knowledge of Microsoft Office applications
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Willing to travel within the local region approximately 25% of the time
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
This role is the highest level of contracting within Company and will report to a Director
Scheduled Weekly Hours
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