Provider Contracting Director jobs in the United States
Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Recently Added Provider Contracting Director jobs
Director of Provider Development & Contracting
- Provider Partners Health Plan
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Indianapolis, IN
FULL_TIME
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Provider Partners is searching for a results-oriented individual, with a proven track record, who is passionate about our mission and can generate positive outcomes based on that mission. The Director of Provider Development & Contracting plays a pivotal role in managing and developing relationships with healthcare providers within our network. This position is responsible for ensuring a high level of provider satisfaction and service while optimizing network performance and strategy.Key Responsibilities:
Provider Relationship Management:- Serve as the primary contact for healthcare providers.
- Maintain and enhance strong, long-term relationships with providers.
- Address and resolve provider inquiries and concerns in a timely and professional manner.
- Conduct provider orientations and provide ongoing education on PPHP policies, procedures, and new initiatives.
Network Development and Management:- Identify, recruit, and contract with new providers to expand our network.
- Negotiate contract terms, rates, and agreements with providers.
- Analyze network performance, identify gaps, and recommend improvements.
- Work collaboratively with internal teams to ensure network adequacy and to develop network strategies.
Performance Monitoring and Reporting:- Monitor provider performance metrics and ensure compliance with contractual and regulatory requirements.
- Prepare and present network performance reports to senior management.
- Evaluate provider satisfaction and recommend strategies for improvement.
Compliance and Regulatory Adherence:- Ensure provider compliance with state, federal, and PPHP regulations and standards.
- Stay abreast of changing regulatory requirements and ensure timely communication to providers and internal stakeholders.
Project Management:- Lead and participate in cross-functional projects aimed at improving network performance and provider satisfaction.
Qualifications:- Bachelor’s degree in healthcare administration, business, or related field required; Master’s degree preferred.
- Minimum of 5-10 years of experience in healthcare network management or provider relations in the state of Indiana.
- Strong knowledge of healthcare industry, contract negotiations, and regulatory compliance.
- Excellent communication and interpersonal skills with the ability to build strong relationships with providers and internal teams.
- Strong analytical and problem-solving skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
- 20 Days Ago
Director, Provider Contracting
- Humana
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Springfield, MO
FULL_TIME
- Become a part of our caring community and help us put health first The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agree...
- 19 Days Ago
Director, Provider Contracting (Hybrid)
- CareFirst
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Baltimore, MD
FULL_TIME
- Resp & Qualifications PURPOSE: We are looking for an experienced people leader in the greater Baltimore metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expec...
- 10 Days Ago
Director, Provider Recruitment and Contracting
- Community Health System - CA
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Fresno, CA
FULL_TIME
- Overview: We got our start 125 years ago as a boarding house and medical facility for people traveling in Central California. If people then could see us now... Today, Community Health System is the r...
- 26 Days Ago
Contracting Officer
- US Office of the Director of National Intelligence
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Bethesda, MD
FULL_TIME
- Duties Oversee the identification, analysis, and participation in the development of acquisition strategies based on requirements (e.g., technical, management, cost, past performance) and establish in...
- 20 Days Ago
IC Contracting Officer
- US Office of the Director of National Intelligence
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Bethesda, MD
FULL_TIME
- Duties The Intelligence Community Senior Procurement Executive (IC SPE) Office within the Policy and Capabilities Directorate is focused on ensuring IC acquisition and procurement is best postured to ...
- 7 Days Ago
Provider Contracting Director jobs at Popular Companies
Income Estimation for Provider Contracting Director jobs
$172,516 to $249,159