As the Senior Provider Contract Specialist you will negotiate and draft physician, hospital and ancillary contracts within an assigned region(s). Through calls and relationship networking, you will identify specialty physicians and ancillary providers needed throughout their regions and vet out when requested by regional staff. Partnering with the Business Development Team, you will produce Letters of Intent to support RFP for new business.
This role reports directly to the Director Network Development and Purchasing at our home in Brentwood TN.
- Contract, negotiate and finalize physician, hospital and ancillary contracts.
- Assist in development of proposal for new business as it relates to the provider network.
- Draft and negotiate amendments & addendums to physician, hospital and ancillary contracts.
- Perform financial analysis through use of claims systems and managed care reimbursement methodologies.
- Communicate with field personnel to educate on role of Network Development department and policies and procedures.
- Research and resolve issues with the claims department, vendor payroll and accounts payable team.
- Implement new business for compliance with operational deadlines.
- Establish and maintain positive working relationships with regional staff.
- Bachelor’s degree preferred
- Three to five (3-5) years of Managed Care or Healthcare experience.
- One to three (1-3) years of experience in working with Managed Care contract terms and reimbursement methods.
- Strong interpersonal skills with the ability to coordinate necessary communication at all levels to promote teamwork.
- QNXT claims payment system experience a plus.
- Excellent written and verbal communication skills.
- Strong Excel and Word knowledge.
- Superior organizational skills and the ability to multi-task high priority projects simultaneously.
- Detail oriented with strong commitment to follow the project through to completion.
- Ability to present information in a group setting to internal and external audiences.
- Ability to travel with overnight stay.
Location/Region: Brentwood, TN, US