Provider Network Contractor

Colorado Access; Aurora (CO, IL); Hybrid; USD 77,000 - 95,000; Full time

Job summary

An established industry player is seeking a Provider Network Contractor to enhance its mission of providing quality health care. In this dynamic role, you will negotiate contracts with health care providers, ensuring that their needs are met while maintaining the organization's standards. You will collaborate with a dedicated team to evaluate network adequacy and address provider concerns, making a significant impact on the health of underserved communities. Join a mission-driven organization that values diversity, equity, and inclusion, and offers a supportive environment for professional growth and development.

Benefits

PTO

Floating Holidays

Company-Paid Holidays

Employee Assistance Program

401K

Medical Insurance

Dental Insurance

Vision Insurance

Tuition Reimbursement

Annual Bonus Program

Qualifications

• Minimum two years’ experience negotiating contracts with health care providers preferred.
• Working knowledge of medical reimbursement platforms required.

Responsibilities

• Develops and maintains relationships with contracted providers.
• Negotiates contracts and manages the entire contracting process.
• Coordinates contract terms and resolves issues with providers.

Skills

Negotiation Skills

Communication Skills

Attention to Detail

Time Management

Knowledge of Medical Reimbursement Platforms

Education

Bachelor’s degree in health administration or business administration

Equivalent combination of experience and/or education

Tools

MS-Office applications (Word, Excel, Access)

Job description

11100 E Bethany Dr, Aurora, CO 80014, USA Req #777

Tuesday, April 8, 2025

The vision of Colorado Access is to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care.

Why should you consider a career with Colorado Access?

We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity, and inclusion.

• Find work/life balance: We offer PTO, floating holidays, nine company-paid holidays, a hybrid work environment, an Employee Assistance Program, and a 401K.
• Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.
• Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.

What you will do:

We are looking for a PROVIDER NETWORK CONTRACTOR who can help shape our vision and support our mission. Here is what the position will look like:

• Develops and maintains positive working relationships with potential contracted providers. Responds to and promptly addresses provider concerns related to current or pending contract provisions or requirements.
• Negotiates contracts with providers, to include addressing language, operational, and reimbursement provision concerns, and utilizes a variety of negotiation strategies and techniques. Coordinates language responses with Director when necessary.
• Maintains knowledge and understanding of current reimbursement methodologies by provider type, contract templates used for each line of business, and organization’s operations to ensure contract offers can be implemented efficiently and accurately.
• In collaboration with the Director, Senior Network Contractors, and other Network Contractors, evaluates network adequacy and ensures that provider capacity targets are achieved within the service area.
• Manages the entire contracting process including provider recruitment, contract negotiation, execution, and implementation.
• Works with contracted providers and internal departments to address and resolve any contract interpretation, operational, or reimbursement issues.
• Coordinates notification and dissemination of contract terms and relevant information to other departments as appropriate.

What you will bring:

Education: Bachelor’s degree in health administration, business administration or related field. Equivalent combination of experience and/or education may substitute, with a preference for four years’ progressive relevant work experience.

Experience: Minimum of two years’ experience negotiating contracts with health care providers (e.g., clinics, medical groups, ancillary providers, and facilities) preferred.

Knowledge, Skills, and Abilities: Working knowledge of the various medical reimbursement platforms including the Resource Based Relative Value System, Medicaid, Ambulatory Payment Classification, and Diagnostic Related Groups required. Basic knowledge of managed care contracting, provider reimbursement methodologies, claims payment operations, medical terminology, and health care delivery systems required. Demonstrates support for the company’s mission, vision, and values. Must have strong negotiation skills and strategy. Position requires excellent written and verbal communication skills. Strong attention to detail, and the ability to handle and prioritize multiple tasks simultaneously required. Ability to deal with multiple levels of staff, work independently with little direction, and initiate work priorities. Must be proficient in MS-Office applications (Word, Excel, Access). May be required to manage multiple priorities and projects with tight deadlines.

Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving.

Together we will be: an innovative and collaborative team who supports each other, the employees, and vision of the company to reach our goals individually, together, and as an organization.

Pay, Perks, and Benefits at Colorado Access:

The compensation for this position is $77,200.00 - $94,800.00 annually. Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status.

In addition to being part of a mission-driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package that includes:

• Medical, dental, vision insurance that starts the first day of the month following start date.
• Supplemental insurance such as critical illness and accidental injury.
• Health care and dependent care flexible spending account options.
• Employer-paid basic life insurance and AD&D (employee, spouse, and dependent).
• Short-term and long-term disability coverage.
• Voluntary life insurance (employee, spouse, dependent).
• Paid time off.
• Tuition reimbursement (based on eligibility).
• Annual bonus program (based on eligibility, requirements, and performance).

Where you will work:

This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’

We are not able to support out-of-state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.

Colorado Access is committed to providing equal opportunities to all people regardless of race, color, national origin, age, sex, genetic information, religion, pregnancy, disability, sexual orientation, veteran status, or any other status protected by applicable law. We strive to maintain a work environment that is free from unlawful harassment and discrimination.