Provider Contract Specialist - Remote

Talentify.io; United States; Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player in healthcare services is seeking a detail-oriented professional to manage provider contracts and pricing arrangements. This remote role offers flexibility and the chance for career advancement while contributing to a mission of accessible healthcare. You will be responsible for negotiating contract terms, ensuring compliance with regulations, and maintaining collaborative relationships with providers. If you have a passion for healthcare and strong analytical skills, this opportunity could be a perfect fit for you.

Qualifications

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

Responsibilities

• Maintain pricing arrangements for provider groups in Health Plan networks.
• Create standard contracts for providers across service areas.
• Ensure compliance with healthcare regulations.

Skills

Contract Negotiation

Healthcare Insurance Management

MS Office Proficiency

Analytical Skills

Education

High School Diploma or equivalent

Bachelor's degree in finance, business, healthcare administration, or communications

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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