Provider Contracting & Network Growth Specialist

Prime Health Services, Inc.; Franklin (TN); On-site; USD 85,000 - 110,000; Full time

Job summary

Prime Health Services, Inc. is seeking a Provider Contractor Specialist to identify, recruit, and negotiate contracts with physicians, provider groups, and ancillary facilities to join the PPO network.

You will negotiate rates and terms in compliance with state and federal requirements, analyze proposed rates, and manage contracting tasks across geographic regions, reporting to the VP of Network Development. Travel may be required to meet with providers.

Qualifications

• Bachelor’s degree or equivalent experience in communications/business/healthcare
• 1+ year of managed care contracting experience
• Excellent written and oral communication, problem solving, and time management
• Collaborative, deadline driven, flexible and self-motivated
• Demonstrated customer service and public relations skills
• Proficiency with Microsoft Office Suite

Responsibilities

• Recruits providers and negotiates PPO contracts ensuring cost effectiveness and compliance
• Manages Specialty Network builds and special projects for PHS Clients
• Negotiates payment rates and terms within corporate requirements and guidelines
• Performs data analytics of proposed rates to align with contracting guidelines
• Meets daily call metrics and completes negotiated contracts as required
• Oversees contracting tasks for defined geographic regions
• Ensures contract proposals are complete and accurate prior to provider review
• Submits contract language for VP review and approval
• Maintains productive relationships with provider community
• Resolves escalated contract issues
• Documents progress in PHS database
• Travel may be required for provider stewardship meetings

Skills

Negotiation

Communication

Time management

Problem solving

Data analysis

Education

Bachelor’s Degree in Communications/Business or healthcare related field

1+ year(s) of managed care contracting/healthcare experience

Microsoft Office Suite proficiency

Tools

Microsoft Office Suite

Job description

Prime Health Services, Inc. is seeking a Provider Contractor Specialist to identify, recruit, and negotiate contracts with physicians, provider groups, and ancillary facilities to join the PPO network.

You will negotiate rates and terms in compliance with state and federal requirements, analyze proposed rates, and manage contracting tasks across geographic regions, reporting to the VP of Network Development. Travel may be required to meet with providers.