Provider Network Strategy & Contracts Specialist

Medica Services Company LLC; Minnetonka (MN); On-site; USD 70,200 - 105,315; Full time

Benefits offered by this job

Medical, dental, vision benefits

PTO and holidays

401K contributions

Volunteer time off

Caregiver services

Job summary

Medica Services Company LLC, a nonprofit health plan serving Minnesota and surrounding states, seeks a Provider Network Manager to develop and maintain a competitive provider network and manage cost performance and trend reporting.

You will negotiate contracts, build strong relationships with hospitals, physicians, and other providers, and ensure adherence to templates and reimbursement standards. This on-site role offers a comprehensive rewards package.

Qualifications

• Bachelor's degree or equivalent experience in healthcare management/administration or healthcare related field.
• Experience of 3+ years in health insurance/healthcare.

Responsibilities

• Develop and maintain provider network yielding a competitive, geographic, stable network that achieves objectives for performance and growth.
• Evaluates and negotiates contracts in compliance with company contract templates, and reimbursement structure standards.
• Builds and maintains positive relationships with providers.
• Communicates contract terms and provisions to provider and internal staff.
• Updates and maintains contract tracking system and contracting calendar within timeframes.

Skills

Managed care knowledge

Provider network administration

Contract negotiation

Attention to detail

Customer service

Education

Bachelor's degree in healthcare management/administration

Tools

Microsoft Word

Excel

Outlook

Job description

Medica Services Company LLC, a nonprofit health plan serving Minnesota and surrounding states, seeks a Provider Network Manager to develop and maintain a competitive provider network and manage cost performance and trend reporting.

You will negotiate contracts, build strong relationships with hospitals, physicians, and other providers, and ensure adherence to templates and reimbursement standards. This on-site role offers a comprehensive rewards package.