Senior Provider Network Contracts Strategist

Medica; St. Louis (MO); On-site; USD 79,000 - 135,000; Full time

Benefits offered by this job

Medical benefits

PTO

401K contributions

Job summary

Medica is a nonprofit health plan serving members across multiple states. The Provider Network Contractor III role is responsible for developing, negotiating, and maintaining a robust provider network to support affordability and performance.

You will build relationships with hospitals, physicians, and ancillary providers to ensure a balanced, compliant network and drive strategic outcomes. Based in an onsite-office setting (St.

Qualifications

• Bachelor's degree or equivalent experience in related field.
• 5+ years of work experience within a healthcare environment.
• Payer/Provider contract negotiation experience.
• Revenue cycle knowledge and/or experience.
• Experience building relationships and establishing trust at all levels.
• Health plan operations and/or provider operations experience.
• Excellent communication (written, verbal and presentation) skills.
• Proven track record of cultivating and maintaining effective, collaborative external relationships where the parties trust information that's conveyed.
• A proven track record as a successful contract negotiator for health care services, provider or health plan.
• Knowledge of provider contracting components and strategies such as but not limited to risk-based contracting, financial models, operational impact and data analytics.

Responsibilities

• Develop and optimize a geographic provider network.
• Lead provider contract negotiation and management.
• Manage provider relationships and address concerns or issues.
• Analyze claims, cost, and utilization patterns to inform contracting decisions.
• Collaborate with legal, finance, provider operations, and medical management teams.

Skills

Communication skills

Analytical thinking

Negotiation

Education

Bachelor's degree or equivalent experience

Job description

Medica is a nonprofit health plan serving members across multiple states. The Provider Network Contractor III role is responsible for developing, negotiating, and maintaining a robust provider network to support affordability and performance.

You will build relationships with hospitals, physicians, and ancillary providers to ensure a balanced, compliant network and drive strategic outcomes. Based in an onsite-office setting (St.