Senior Provider Engagement & Contracting Lead

EmblemHealth, Inc.; New York (NY); Hybrid; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth is seeking a Provider Contracting professional to build and optimize relationships with providers, oversee contracting and implementation of new programs, and ensure accurate contract administration. You will support provider education, policy communication, and issue resolution across internal departments.

The role focuses on negotiation of terms, compliance, and performance analytics to improve access, quality, and financial outcomes for the provider network.

Qualifications

• Bachelor's degree required in a health-related field or equivalent.
• 4-6+ years of relevant professional experience required.
• 3+ years in healthcare analytics, contracting, or plan/provider operations required.
• Additional experience or training may substitute for education requirements.
• Demonstrated understanding of standard analytic methodologies and tools required.
• Excellent organizational, project management, and relationship management skills required.
• Excellent verbal, written, and interpersonal communication skills required.
• Proficiency with MS Office (Word, Excel, PowerPoint, Teams, Outlook) required.
• Understanding of clinical, economic, and quality components of healthcare required.

Responsibilities

• Recommend innovative contracting strategies to maximize cost containment, access, value, and quality.
• Negotiate and communicate contract terms, payment structures, and reimbursement rates with providers.
• Ensure accurate contract and rate load implementations in a timely manner.
• Remain current on provider reimbursement methodologies and trends.
• May recruit providers to address network deficiencies.
• Understand market trends and regulatory models to inform decisions.
• Oversee contract performance, renewals, and terminations with analytics.
• Use data to identify opportunities and coordinate action plans with provider entities.
• Coordinate cross-departmental collaboration for contract issues and education.

Skills

Healthcare analytics

Contracting

Provider operations

MS Office proficiency

Communication

Relationship management

Project management

Healthcare knowledge

Education

Bachelor's degree in Health Care-related field, Public Administration, or Management

Job description

EmblemHealth is seeking a Provider Contracting professional to build and optimize relationships with providers, oversee contracting and implementation of new programs, and ensure accurate contract administration. You will support provider education, policy communication, and issue resolution across internal departments.

The role focuses on negotiation of terms, compliance, and performance analytics to improve access, quality, and financial outcomes for the provider network.