Senior Strategic Provider Network Contract Lead

Providence Health Plan Group; Renton (WA); Hybrid; USD 54,346 - 84,364; Full time

Benefits offered by this job

Retirement 401(k) Savings Plan with employer matching

Health care benefits (medical, dental, vision)

Paid parental leave and vacation benefits

Disability insurance

Job summary

Providence Health Plan Group in Renton, WA, is seeking an experienced professional to manage the Network Plan and ensure compliance with URAC and DoD standards. The role involves developing and educating network providers on health plan criteria, as well as conducting negotiations with providers for competitive reimbursement terms.

The ideal candidate will have a strong background in managed care operations, extensive experience in contract negotiations, and a Bachelor’s Degree in a related field. The position offers a hybrid work model and a comprehensive benefits package.

Qualifications

• Minimum of 5 years in managed care operations.
• Experience with capitated medicine and health plan contracts.
• Strong skills in contract negotiation and project management.

Responsibilities

• Develop and maintain the Network Plan and provider handbook.
• Conduct contract negotiations with network providers.
• Ensure compliance with URAC, DoD standards, and contracts.

Skills

Managed care operations

Contract negotiation

Capitated medicine

Project management

Education

Bachelor’s Degree in related field

Job description

Providence Health Plan Group in Renton, WA, is seeking an experienced professional to manage the Network Plan and ensure compliance with URAC and DoD standards. The role involves developing and educating network providers on health plan criteria, as well as conducting negotiations with providers for competitive reimbursement terms.

The ideal candidate will have a strong background in managed care operations, extensive experience in contract negotiations, and a Bachelor’s Degree in a related field. The position offers a hybrid work model and a comprehensive benefits package.