Provider Contract Specialist

Green Key Resources; United States; Remote; USD 100,000 - 135,000; Full time

Job summary

A leading company in the healthcare industry seeks a Contract Specialist to manage provider contracts and enhance financial performance. The role includes monitoring contracts, negotiating terms, and ensuring compliance with regulations. Ideal candidates will have strong communication skills and experience in healthcare-related contracting.

Qualifications

• Experience in healthcare contract management.
• Mid-senior level role, ideally with familiarity in Idaho contracting.
• Strong negotiation and communication skills.

Responsibilities

• Monitor and manage financial performance of contracts.
• Develop reimbursement strategies for healthcare costs.
• Lead negotiations and manage contract implementation.

Skills

Contract management

Provider relations

Negotiation

Financial performance analysis

Project management

Job description

*Can be remote anywhere in US however must have experience in Idaho for contracting ancillary and physician provider types

• Monitor’s adequacy and financial performance of all assigned contracts.
• Identifies provider payment or utilization variations and ensures follow-up action.
• Maintains active communication with assigned providers and communicates issues or questions raised by provider office with key stakeholders. Responds to provider request for information regarding company contracting programs and policies.
• Develops and implements reimbursement strategies designed to control healthcare costs by reimbursing providers appropriately.
• Implements standardized contracts with providers. Participates in the negotiation of contracts for new and existing provider networks.
• Prepares contract development and template standardization and ensures they meet legal and regulatory requirements.
• Ensures accurate implementation and administration of assigned contracts, amendments, and projects.
• Organizes, prepares, and delivers presentations to provider groups and/or office staff.
• Maintains documentation related to processes and procedure, training materials, program descriptions, and technical program requirements.
• Performs other duties and responsibilities as assigned.
• Manages contracting process including provider recruitment, contract negotiations, execution, and implementation of contract and payment methodologies.
• Prepares and presents financial performance reports on assigned contracts to leadership.
• Leads project management responsibilities for integrated networks and other strategic plans.

Seniority level

• Mid-Senior level

Employment type

• Contract

Job function

• Project Management

Industries

• Hospitals and Health Care

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