What are the responsibilities and job description for the Provider Network Contract Negotiator (Hybrid/Remote Option-NC) position at Partners Health Management?
Competitive Compensation & Benefits Package!
Position eligible for –
- Annual incentive bonus plan
- Medical, dental, and vision insurance with low deductible/low cost health plan
- Generous vacation and sick time accrual
- 12 paid holidays
- State Retirement (pension plan)
- 401(k) Plan with employer match
- Company paid life and disability insurance
- Wellness Programs
- Public Service Loan Forgiveness Qualifying Employer
See attachment for additional details.
Office Location: Hybrid/Remote option; Available for any of Partners' NC locations
Closing Date: Open Until Filled
Primary Purpose of Position: This position will assist the Provider Network Contract Manager in identifying, negotiating, and contracting with Medicaid healthcare providers to join Partners’ health plan network. This position will be responsible for drafting, implementing, and monitoring of all provider contracts, ensuring all financial requirements and obligations are accurately identified and executed.
Role and Responsibilities:
- Perform healthcare provider contracting services.
- Recruitment and contracting efforts may include, but not be limited to, telephone calls, email, regular mail, facsimile transmissions and visits to targeted provider offices to initiate, negotiate, and procure executed participating provider agreements.
- Leads all aspects of negotiations for facility, physician and network managed care agreements under general supervision from management
- Coordinates, analyzes and develops all financial and operational aspects of contract proposals, including drafting and nominally redlining agreements and amendments.
- Works with the Contracts Managers and Contracting Director for Provider Network to develops a negotiation strategy, assessing the strengths of each party in the negotiation.
- Coordinates with internal departments and contracted providers to implement and maintain contract compliance.
- Prepares correspondence to managed care providers.
- Works with the Contract Coordinators to ensure a workflow and contract management process follows the contracting to include loading into contract management system and preparation of contract summaries outlining contract terms for internal stakeholders.
- Establishes and maintains relationships with providers and support them through connection with the Provider Relations team.
- Acts as a professional resource to answer all contractual questions and facilitate issue resolution with internal and external stakeholders.
- Assists with development and maintenance of reports used to track contracting activity and report outcomes.
- Performs other duties as assigned.
Knowledge, Skills and Abilities:
- Considerable knowledge of state and federal fiscal rules and regulations
- Knowledge of and ability to explain and apply the provisions of contractual practices adopted by State Government
- Strong problem solving, decision-making and negotiating skills
- Strong written and verbal communication skills
- Excellent organization skills
- Ability to multi-task and meet deadlines
- Considerable knowledge of the laws, regulations and policies that govern the program
- Exceptional interpersonal and communication skills
- Strong problem solving, negotiation, arbitration, and conflict resolution skills
- Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint
- Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements
- Ability to make prompt independent decisions based upon relevant facts
- Ability to establish rapport and maintain effective working relationships
- Ability to act with tact and diplomacy in all situations
- Ability to maintain strict confidentiality in all areas of work
Education and Experience Required: Bachelor’s Degree and four years of negotiation experience in managed care or a related field (such as healthcare finance or patient financial services) with a healthcare provider or insurer/payer, auditing, accounting, finance, or contract management; or an equivalent combination of education and experience. A combination of relevant experience may be considered in lieu of a Bachelor’s degree.
Must have ability to travel as indicated.
Must reside in North Carolina or within 40 miles of the NC border.
Education and Experience Preferred: Familiarity with State health care programs preferred.
