Provider Contract Specialist - Remote

Marshfield Clinic; Marshfield (WI); Remote; USD 45,000 - 70,000; Full time

Job summary

An established industry player in healthcare services is seeking a dedicated professional to join their team. This role offers the chance to work remotely with a flexible schedule while contributing to the development of compliant networks and provider recruitment. You will engage in contract negotiations, ensuring compliance with healthcare regulations and standards. The organization values career advancement and fosters a collaborative environment that enriches lives through accessible healthcare. If you are passionate about making a difference in the healthcare sector, this opportunity is perfect for you.

Qualifications

• Experience in healthcare insurance or insurance network management.
• Proficiency in analyzing and negotiating contract terms.

Responsibilities

• Maintain and coordinate pricing arrangements for provider groups.
• Create standard contracts for providers across the Health Plan service area.

Skills

Healthcare Insurance Experience

Contract Negotiation

MS Office Proficiency

Analytical Skills

Education

High School Diploma

Bachelor's Degree in Finance or Healthcare Administration

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely with a flexible schedule
- Collaborative and innovative work environment
- Involvement in building compliant networks and provider recruitment
- Commitment to enriching lives through accessible and compassionate healthcare

What to Expect (Job Responsibilities):
- Maintain and coordinate pricing arrangements involving provider groups and facilities joining the Health Plan networks
- Create standard contracts for providers across the Health Plan service area
- Analyze, communicate, and negotiate financial impacts of contract terms and reimbursement rates with providers
- Ensure compliance with healthcare regulations and standards
- Conduct occasional travel for face-to-face meetings and conferences

What is Required (Qualifications):
- Minimum educational requirement: High School Diploma or equivalent
- Experience in healthcare insurance or insurance network management
- Proficiency in analyzing and negotiating contract terms and payment structures
- Strong skills in MS Office applications
- Must not be excluded from participation in federally funded programs, including Medicare and Medicaid

How to Stand Out (Preferred Qualifications):
- Bachelor's degree or equivalent experience in finance, business, healthcare administration, or communications
- Prior experience with behavioral healthcare reimbursement
- Capability for occasional travel, including overnight trips for meetings and conferences

#HealthcareServices #ProviderContracts #RemoteWork #CareerGrowth #EqualOpportunityEmployer

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