Health Partner Network & Contracting Leader

caresource; Georgia; Sur place; USD 72 000 - 116 000; Plein temps

Résumé du poste

CareSource is seeking a Health Partner Network Manager to execute the contracting strategy and develop provisions based on cost and quality metrics. The role monitors key market metrics and leads negotiations across hospital, ancillary, physician, and behavioral health contracts.

Responsibilities include loading/credentialing, template development, and ensuring regulatory compliance while building provider networks and driving value-based reimbursement initiatives.

Qualifications

• Bachelor's degree in a healthcare related field is required.
• Master's degree is preferred.
• Minimum 3 years of healthcare experience, incl. 1 year in managed care provider relations or contracting.
• Managed care experience is highly preferred.

Responsabilités

• Create, execute and administer value based reimbursement strategies.
• Negotiate hospital, ancillary, physician and behavioral health contracts.
• Develop contract language and review with legal to create templates.
• Analyze financial data to establish rates with leadership and Finance.
• Recruit and onboard new providers and monitor loading/credentialing.
• Ensure compliance with federal and state laws and regulations.
• Mentor junior contractors and provide training to staff.

Connaissances

Negotiation skills

Communication skills

Critical thinking

Time management

Training/teaching

Teamwork

Decision making

Formation

Bachelor's degree in healthcare field

Master's degree preferred

Outils

Microsoft Outlook

Microsoft Word

Microsoft Excel

Description du poste

CareSource is seeking a Health Partner Network Manager to execute the contracting strategy and develop provisions based on cost and quality metrics. The role monitors key market metrics and leads negotiations across hospital, ancillary, physician, and behavioral health contracts.

Responsibilities include loading/credentialing, template development, and ensuring regulatory compliance while building provider networks and driving value-based reimbursement initiatives.