Senior Network Contract & Provider Relations Lead

Providence; Renton (WA); Ibrido; USD 54.000 - 84.000; Tempo pieno

Vantaggi offerti da questo lavoro

401(k) matching

Health, dental, vision benefits

Life insurance

Disability insurance

Paid time off

Well-being resources

Descrizione del lavoro

Providence is seeking a senior Network Contracts Leader to manage negotiations with hospitals, physician groups and ancillary services, ensuring timely contracting and alignment with TRICARE/DoD requirements. You will lead complex networks, educate providers, and oversee utilization management to support the Health Plan.

The role emphasizes contract language mastery, capitation understanding, and alignment with USFHP policies.

Competenze

• 5 years of Managed care operations.
• Extensive experience and understanding of capitated medicine, contracted networks and health plan contracts.

Mansioni

• Lead contract negotiations for reimbursement terms and contract language with network providers across hospitals, physician groups and ancillary services.
• Conduct negotiations and complete the contracting process in a timely manner according to USFHP principles and DoD contract terms.
• Educate providers and network members on Health Plan criteria and processes.
• Oversee non-clinical utilization management functions of the Health Plan.
• Ensure compliance with DoD contract regarding network and utilization issues.

Conoscenze

Managed care operations

Capitated medicine

Contracted networks

Health plan contracts

Formazione

Bachelor’s Degree in related field

Descrizione del lavoro

Providence is seeking a senior Network Contracts Leader to manage negotiations with hospitals, physician groups and ancillary services, ensuring timely contracting and alignment with TRICARE/DoD requirements. You will lead complex networks, educate providers, and oversee utilization management to support the Health Plan.

The role emphasizes contract language mastery, capitation understanding, and alignment with USFHP policies.