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)
ESSENTIAL DUTIES AND RESPONSIBILITIES
CULTURE OF EXCELLENCE BEHAVIOR EXPECTATIONS
To perform the job successfully, an individual should demonstrate the following behavior expectations:
Quality - Follows all policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness, giving attention to detail; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of Service principles; Meets all assigned commitments; Abides by Mercyhealth confidentiality and security policies; Shows respect and sensitivity for cultural differences; Effectively communicates all relevant information to partners; Applies system-wide thinking and approach regarding all applicable processes and functions.
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
Cost - Conserves organization resources; Understands and applies fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; Contributes to profits and revenue.
EDUCATION & EXPERIENCE
Bachelor’s degree required. JD (Juris Doctor) preferred.
Experience in healthcare and/or supply chain preferred but not required.
Minimum of two years of experience in supply chain contracting or a related legal field.
CERTIFICATION/LICENSURE
Professional certification in related field preferred
ADDITIONAL REQUIREMENTS
Passing the Driver’s License Check and/or Credit Check (for those positions requiring).
Passing the WI Caregiver Background Check and/or IL Health Care Workers Background Check.
Must be able to follow written/oral instructions.
OTHER SKILLS AND ABILITIES
WORK ENVIRONMENT
Normal office work environment and is usually quiet
Occupational Exposure: Category C: No partners in the specified job classification have occupational exposure.
AGE OF PATIENTS SERVED
Non-Specific Task (N/A)
INFORMATION ACCESS
Partner may access strategic and planning data needed to perform their job duties as directed by the Manager or Director.
WORK CONTACT GROUP
Physicians, vendors, hospitals and other hospital and clinic personnel
SPECIAL PHYSICAL DEMANDS
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, and feel; Also, to speak and hear. Specific vision abilities required for this job include close vision, distance vision, and peripheral vision.
LEVEL OF SUPERVISION
Ability to work independently and with guidance and support from Manager and Director.
SUPERVISESNone
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