Network Contract & Reimbursement Lead

Aspirus, Inc; Town of Wausau (WI); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Full benefits package

Paid time off

Retirement plans

Wellness program

Job summary

Aspirus Health in Wausau, Wisconsin is seeking a Network Management Partner to join our Aspirus Health Plan team. The role negotiates and executes physician, hospital, and ancillary contracts, provides guidance on reimbursement strategies, and helps develop procedures to increase market share.

You will maintain active communication with the provider network and serve as the point of contact for escalated issues; travel as needed; full-time or 1.0 FTE.

Qualifications

• Bachelor's Degree preferred in Healthcare Administration, Finance or Business Management.
• Previous network development and provider contracting experience.
• Possesses a valid driver's license. Occasional travel is required.
• Knowledge of NCQA and CMS quality standards.
• Knowledge of state and federal requirements for network adequacy, contracting, and compliance.
• Efficient in Microsoft Excel, Outlook, PowerPoint, and Word.
• Annual competencies as required by Aspirus and/or various regulatory agencies based on entity and/or job position.

Responsibilities

• Negotiates and executes physician, hospital, and ancillary contracts for Aspirus Health Plan.
• Provides guidance and governance on reimbursement strategies.
• Develops procedures to increase market share and enhance competitiveness of all Aspirus Health Plan products.
• Maintains active communication with provider network and serves as the point of contact for escalated issues.

Skills

Negotiation

Contract management

Provider contracting

Excel

Outlook

PowerPoint

Word

Travel

Education

Bachelor's Degree in Healthcare Administration or Finance or Business Management

Tools

Microsoft Excel

Outlook

PowerPoint

Word

Job description

Aspirus Health in Wausau, Wisconsin is seeking a Network Management Partner to join our Aspirus Health Plan team. The role negotiates and executes physician, hospital, and ancillary contracts, provides guidance on reimbursement strategies, and helps develop procedures to increase market share.

You will maintain active communication with the provider network and serve as the point of contact for escalated issues; travel as needed; full-time or 1.0 FTE.