Contract Negotiator III

Envolve Pharmacy Solutions; Pennsylvania; Hybrid; USD 68,000 - 124,000; Full time

Job summary

A healthcare solutions provider in Pennsylvania is seeking a Contract Negotiator III. You will recruit and develop healthcare provider networks, ensuring compliance with contracts. Ideal candidates have a Bachelor’s degree and at least 4 years of relevant experience. A comprehensive benefits package and competitive pay are offered, with a focus on workplace flexibility.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Flexible work schedules

Qualifications

• 4+ years of contracting, contract analysis, or provider relations experience.
• Working knowledge of Medicaid and Medicare programs preferred.

Responsibilities

• Recruit and develop network for assigned providers.
• Facilitate contract compliance and accurate claims adjudication.
• Coordinate with internal departments for contract processes.

Skills

Contract negotiation

Provider relations

Healthcare administration

Education

Bachelor’s degree in Healthcare Administration or related field

Job description

Join to apply for the Contract Negotiator III role at Envolve Pharmacy Solutions.

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You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose

Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State guidelines. Ensure that all necessary documentation and information are included.

Responsibilities

• Recruit and develop network for a region and set of providers
• Lead assigned recruitments (i.e., physician, hospital and ancillary) and ensure they result in complete and accurate standard contracts that meet objectives
• Facilitate and oversee the provider set-up and contract configuration to ensure accurate claims adjudication
• Initiate contact and identify potential providers by geographic and specialty needs and update database
• Coordinate with internal departments and contracted providers to implement and maintain contract compliance

Education/Experience

Bachelor’s degree in Healthcare Administration, Business Administration, Finance, related field or equivalent experience. 4+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician’s office/group setting. Working knowledge of State and/or Federal health care programs preferred (Medicaid, Medicare).

Compensation & Benefits

Pay Range $68,700.00 - $123,700.00 per year

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Equal Opportunity

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Job Details

• Seniority level: Not Applicable
• Employment type: Full-time
• Job function: Legal
• Industries: Hospitals and Health Care and Insurance

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