- Ensure field contractors comply with contracting standards, regulatory requirements, governing standard templates, reimbursement standards, network and contract policy, and the non-standard deviation process
- Provide direct and ongoing guidance and support to field contractors on contracting standards, LOB regulations, and use of the Contract Management System (Contract Manager)
- Support field contractors on non-standard issues
- Work closely with Legal, Compliance, and Matrix Leadership on policy, language, and “ability to administer” issues
- Support reporting and compliance with the Governance non-standards review process
- Work within the Governance Department responsible for Network Standards, Systems, Contracting Governance, and Network Governance for Providers and Suppliers
- Support the broader NBS Organization and larger NBS Governance Team
Requirements
- Bachelor’s degree and 6 years’ experience in health care, health insurance, or strategic consulting environment OR Bachelor’s degree and 5 years consulting experience involving strategic planning, business development, and financial management operations OR 8 years of experience in strategic planning, market research, network management, or product development in the health care industry
- Experience leading and formulating strategy with the ability to build strong connections with people and teams
- Ability to drive results by working across departments in a matrixed environment
- Interpersonal skills, including presentation, written and verbal communication
- Experience with business analytics and information synthesis
- Knowledge of strategic planning techniques and industry trends
- Ability to work within a very fast-paced, quickly evolving organization and manage multiple, complex priorities
- Ability to work directly with corporate leadership
- Analytical, program management, and problem-solving skills
- Strongly preferred background in Compliance, Regulatory Ops, or Audit
- Subject Matter Expertise in Contracting, Negotiating, Provider/Supplier Services, Project Management, Health Plan Operations, Health Plan Regulations, and Accreditation Standards
- High degree of business acumen and professionalism
- Ability to translate complex conditions and identify solutions for risk mitigation
- Ability to foster collaboration, value others’ perspectives, and gain support and buy-in for organizational proposals
- Matrix management skills and high levels of business acumen
- Ability to drive and lead an organization through change
- Excellent interpersonal and relationship management skills
Core Competencies
Demonstrates expertise in Contracting, Regulatory Compliance, and Strategic Planning within the health care industry, with a strong ability to manage complex priorities and foster collaboration across departments. Proven skills in business analytics, problem-solving, and relationship management are essential for driving results in a fast-paced environment.
Highest-signal resume keywords
- Contract Management System
- Regulatory Compliance
- Strategic Planning
- Business Analytics
- Project Management
ATS Optimization Keywords
Hard Skills
- Contracting
- Negotiating
- Provider Services
- Health Plan Operations
- Health Plan Regulations
- Accreditation Standards
- Program Management
- Information Synthesis
- Market Research
- Financial Management
Soft Skills
- Interpersonal Skills
- Presentation Skills
- Written Communication
- Verbal Communication
- Relationship Management
Industry Keywords
- Health Care
- Health Insurance
- Strategic Consulting
- Compliance
- Regulatory Ops
- Audit
- Matrix Management
- Change Management
Tools & Technologies