Provider Contracts & Network Lead

Paradigm Corp.; Texas; On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health insurance options (PPO/HDHP/HMO

401(k) matching contributions

Life and disability insurance

Flexible spending accounts and HSA

Paid time off and holidays

Volunteer day

Job summary

Paradigm Corp. seeks a Provider Contracts professional to develop and implement network and contract strategies, focusing on ambulatory surgery centers and specialists to meet client needs.

The role requires 3–5 years in healthcare administration or provider services, strong communication, and problem-solving abilities, with up to 10% travel. Collaboration with legal and compliance is essential.

Qualifications

• Bachelor’s Degree in a related field (Business Administration, etc.) or equivalent experience.
• 3 to 5 years of experience in Healthcare Administration, Network Development, Managed Care, and/or Provider Services.
• Superior interpretation and research skills to identify problems and resolve them promptly.
• Ability to organize, coordinate, and accomplish a high volume of work with quality.
• Maintain confidentiality and comply with HIPAA.

Responsibilities

• Executes provider contracts for acceptable reimbursement rates as determined by client requirements and market ranges.
• Maintains a system to track contract negotiation and sales activity using company software.
• Directs preparation and negotiations of provider contracts with ambulatory surgery centers, physicians, hospitals, and other providers.
• Oversees maintenance of all Provider contract information for the territory and updates templates for compliance.
• Seeks and creates single case agreements to fulfill gaps as needed by the business.
• Develops relationships with providers and feedback on response time and documentation.
• Performs additional duties as directed by management.
• Maintains reliable attendance and supports required quality/quantity of work.
• Uses AI tools to improve day-to-day tasks and output quality, adopting new technologies per guidelines.
• Demonstrates a customer-first mindset and collaborates to meet customer needs.

Skills

Communication

Interpersonal skills

Analytical skills

Problem solving

Time management

Education

Bachelor's Degree in related field

Tools

Excel

Word

Job description

Develops and implements provider network and contract strategies, identifying the ambulatory surgery centers and specialists in geographic locations in which to concentrate resources for purposes of establishing a sufficient network of participating providers to serve and exceed the needs of our clients.

DUTIES AND RESPONSIBILITIES:

• Executes provider contracts for acceptable reimbursement rates as determined by client requirements and prevailing market ranges.
• Maintain a system to track contract negotiation and sales activity on an ongoing basis through company provided software applications.
• Directs the preparation and negotiations of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with ambulatory surgery centers, physicians, hospitals, and other health care providers as needed.
• Oversees the maintenance of all Provider contract information for given territory. Works with legal and corporate on an as needed basis to modify contract templates to ensure compliance with all contractual and/or regulatory requirements.
• Seeks, contacts and creates single case agreements (SCA) to fulfill GAP’s as needed by the business.
• Develops relationships with providers and offers feedback if there are deficiencies in their response time, scheduling time and/or providing medical documentation in a timely manner.
• Perform additional duties as identified and directed by management.
• Maintain reliable and predictable attendance during scheduled work hours.
• Utilizes AI tools to support day-to-day tasks, improve efficiency, and enhance output quality. Adopts new technologies as trained and applies them in alignment with established processes and guidelines.
• Demonstrates a customer-first mindset by developing a broad and deep (where appropriate) understanding of Paradigm organization, products, operations, and customers. Prioritizes collaboration to meet customer needs and expectations and takes personal accountability for service quality.
• Responsible for complying with Paradigm Information Security requirements and policies, for safeguarding Paradigm or Paradigm related passwords, and for notifying Paradigm of any Information Security incidents per policy SEC 10-12 Information Security Incident Management.

QUALIFICATION REQUIREMENTS:

• Bachelor’s Degree in a related field (Business Administration, etc.,) or equivalent experience.
• 3 to 5 years of experience in Healthcare Administration, Network Development, Managed Care, and/or Provider Services.
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
• Ability to maintain attendance to support required quality and quantity of work.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
• Superior interpretation and research skills to readily identify problems, get to the root cause and achieve prompt resolution to problems and issues including analytical skills
• Ability to organize, coordinate, and accomplish a high volume of work with minimum impact on quality
• Exceptional interpersonal relations skills.
• Superior verbal and written communication skills.
• Knowledge of Excel and Word.
• This position may require up to 10% travel.