Senior Ancillary Network & Provider Manager

Healthfirst; New York (NY); Hybrid; USD 69,000 - 100,000; Full time

Job summary

Healthfirst is seeking an Ancillary Services Contractor to develop and maintain an extensive ancillary provider network in the New York area. You will focus on lowering claims costs, improving quality of care, and increasing provider satisfaction through contract negotiations and education.

Responsibilities include credentialing review, creating contracts, and resolving claims issues while coordinating with multiple departments to ensure accurate fee schedules and timely payments.

Qualifications

• Experience managing or performing high level servicing to a portfolio of customers/providers.
• Contracting experience with knowledge of reimbursement methodologies for ancillary services.
• Ability to work independently in a dynamic environment and manage multiple tasks.

Responsibilities

• Develop and maintain an Ancillary provider network to lower costs and improve care.
• Negotiate and execute provider contracts, including OON arrangements.
• Monitor contracted providers, load accurate demographics and fee schedules.
• Educate credentialed providers on policies, billing, and portal usage.
• Collaborate cross-departmentally to resolve claims issues and denials.

Skills

Provider recruitment

Contract negotiations

Credentialing

Claims resolution

Network development

Provider outreach

Data analysis

Communication skills

Relationship management

Education

High School Diploma

Job description

Healthfirst is seeking an Ancillary Services Contractor to develop and maintain an extensive ancillary provider network in the New York area. You will focus on lowering claims costs, improving quality of care, and increasing provider satisfaction through contract negotiations and education.

Responsibilities include credentialing review, creating contracts, and resolving claims issues while coordinating with multiple departments to ensure accurate fee schedules and timely payments.