Provider Network Contracting Lead (Remote/Hybrid)

Search Results; United States; Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Flexible work options

Hybrid work schedules

Competitive pay

PTO including holidays

Health insurance Day 1

401(k)

Job summary

AmeriHealth Caritas is seeking a Network Contractor to develop and negotiate provider contracts in a hybrid role based in Louisiana. The position supports network development, provider satisfaction, education, and communication across the provider network.

The successful candidate will negotiate contracts, convert SCAs to contracted status, recruit providers to fill gaps, and ensure compliance with federal and state regulations while supporting plan quality initiatives and value-based

Qualifications

• Associates Degree required.
• Bachelor's Degree preferred.
• Master's Degree highly preferred.
• Minimum of three (3) years of Account Executive experience.
• Minimum of one (1) year of contract negotiation experience.

Responsibilities

• Supports network development strategy.
• Assist Leader with provider satisfaction, education and communication.
• Negotiate contracts to execute on network strategy and ensure compliant network.
• Negotiate SCA rates and convert SCA providers to contracted.
• Recruit and contract providers based on identified gaps.
• Ensure contracts comply with Federal and State rules, policies and procedures.
• Support quality initiatives such as HEDIS, CAHPS and NCQA/URAC.
• Lead negotiations for Value Based Contracting with AE.
• Collaborate with Corporate Provider Network Management on contracting schedule.
• Develop resources for complex specialties (e.g., FQHCs, BH, anesthesia).
• Review contract language and consult with legal for best terms.

Skills

Contract negotiation

Provider contracting

Communication skills

MS Office

Education

Associates Degree

Bachelor's Degree

Master's Degree

Tools

MS Office Suite

Job description

AmeriHealth Caritas is seeking a Network Contractor to develop and negotiate provider contracts in a hybrid role based in Louisiana. The position supports network development, provider satisfaction, education, and communication across the provider network.

The successful candidate will negotiate contracts, convert SCAs to contracted status, recruit providers to fill gaps, and ensure compliance with federal and state regulations while supporting plan quality initiatives and value-based