Provider Network Growth & Contracts Specialist

DOCTORS HEALTHCARE PLANS, INC.; Florida; On-site; USD 100,000 - 150,000; Full time

Job summary

DOCTORS HEALTHCARE PLANS, INC. in South Florida seeks a Network Development professional to expand our provider network and negotiate comprehensive agreements. You will ensure compliance with CMS/AHCA guidelines, manage credentialing, and drive data integrity within the contract process.

Travel between Miami/Dade locations is required. A bachelor’s degree in health services administration or related field is preferred, with strong negotiation and organizational skills to support growth and

Qualifications

• Excellent negotiation skills.
• Excellent oral and written communication skills.
• Bachelor’s degree in health services administration, business or related field or equivalent.
• Knowledge of Medicare Advantage operational and regulatory guidelines (CMS, AHCA) is a plus.
• Ability to travel between Miami/Dade locations.

Responsibilities

• Negotiate provider agreements for PCP, medical specialty, ancillary and hospital services.
• Ensure contract language complies with CMS, AHCA and state regulations.
• Obtain credential information for new providers and facilities.
• Maintain completeness of information in agreements and provider data.
• Conduct claims and utilization research for re-contracting existing providers.
• Perform departmental projects as requested by VP Network Development.

Skills

Negotiation skills

Communication skills

Bilingual English/Spanish

Organizational skills

Customer service

Adaptability

Problem solving

Education

Bachelor's degree in health services administration, business or related field

Job description

DOCTORS HEALTHCARE PLANS, INC. in South Florida seeks a Network Development professional to expand our provider network and negotiate comprehensive agreements. You will ensure compliance with CMS/AHCA guidelines, manage credentialing, and drive data integrity within the contract process.

Travel between Miami/Dade locations is required. A bachelor’s degree in health services administration or related field is preferred, with strong negotiation and organizational skills to support growth and