Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Job Summary
Responsible for managed care portfolio performance for assigned payors. Work with Management on implementation of contracting strategy for the System. Independently negotiate contract language and rates for minor payors, or major payors when the scope of the negotiation is limited. Negotiate payor agreements with Director/AVP support. Monitor contract performance versus expected, and recommend any action needed.
Essential Functions
Physical Requirements
Perform most work under normal office conditions; may include sitting for long periods of time, standing, walking, using repetitive wrist/arm motion or lifting articles up to twenty-five pounds.
Education, Experience and Certifications
Bachelor's degree required, Master's degree preferred (MBA or MHA preferred). Minimum of 3 years experience as a contract negotiator with a large provider or 5 years small provider or payor experience as a contract negotiator with a Bachelor's degree. -OR- Minimum of 2 years experience as a contract negotiator with a large provider or 4 years small provider or payor experience as a contract negotiator with a Master's degree.
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0 Provider Contracting Manager jobs found in Charlotte, NC area