Senior Provider Contracting & Network Strategy Lead

HCSC; Nashville (TN); Remote; USD 121,000 - 225,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a seasoned Network Contracting Manager to develop and manage contracting strategies for commercial and government networks, draft reimbursement agreements, and oversee contracts for hospitals and large groups. This role requires a bachelor’s degree and 5 years in healthcare contracting plus 5 years of management, with travel as needed.

The position offers telecommute options within the continental United States and emphasizes delivering

Qualifications

• Bachelor’s degree plus 5 years’ experience in hospital/health care contracting or hospital/physician relations.
• 5 years management experience.
• Experience with large integrated health care delivery systems and complex reimbursement strategies.
• Experience proactively developing and maintaining relationships with health care provider leadership teams.
• Knowledge of outpatient and provider reimbursement strategies and policies.

Responsibilities

• Develop and manage contracting strategies for operations relative to commercial and government networks.
• Accountable for development, negotiation, and completion of reimbursement contracts. Ensure network adequacy for commercial and government networks.
• Draft reimbursement agreements and negotiate contracts for hospitals, large professional groups with special pricing, and hospital-based physicians, for commercial and government networks.
• Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management.
• Develop strategies, draft agreements, and negotiate contracts for newly recognized categories of providers.
• Oversee the analysis and reporting required to develop reimbursement strategies and take corrective action as needed.
• Accountable for resolution of issues and contractual disputes.
• Ensure staff meets/exceeds goals, objectives and initiatives. Ensure staff is trained, positions are filled, and employees receive communications on changes, etc.
• Accountable for budget, operational reporting and financial reporting.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company related business.
• Maintain effective communication with leadership within the organization regarding developments within areas of assigned responsibilities and perform special projects as required or requested.

Skills

Contract negotiations

Leadership

Budget management

Healthcare contracting

Team management

Communication

Relationship building

Travel readiness

Education

Bachelor’s degree

Job description

Health Care Service Corporation (HCSC) is seeking a seasoned Network Contracting Manager to develop and manage contracting strategies for commercial and government networks, draft reimbursement agreements, and oversee contracts for hospitals and large groups. This role requires a bachelor’s degree and 5 years in healthcare contracting plus 5 years of management, with travel as needed.

The position offers telecommute options within the continental United States and emphasizes delivering