Strategic Provider Contract Lead

EmblemHealth; New York (NY); On-site; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth in New York seeks a Provider Relations Professional to build and optimize our network through strategic contracting, education, and issue resolution. You will serve as a liaison among facilities, professionals, and plan departments, driving contract load accuracy and program implementation.

Responsibilities include negotiating terms, overseeing quarterly renewals, analyzing financial impact, and coordinating with Claims, Care Management, and Credentialing to keep contracts compliant

Qualifications

• Bachelor's degree in a health care-related field, public administration, or management.
• 4–6+ years of direct provider relations experience.
• Strong customer service skills to maintain excellent rapport with providers and staff.
• Ability to collaborate across multiple Plan departments to resolve issues.

Responsibilities

• Recommend innovative contracting strategies to maximize cost containment, access and quality.
• Negotiate and communicate contract terms, payment structures, and reimbursement rates.
• Stay current on provider reimbursement methodologies and trends to inform strategy.
• Assist providers with contract disputes and ensure timely contract load implementations.
• Coordinate ongoing network participation and performance, including renewals and terminations.
• Analyze financial impact of contracts and terms and support audits when needed.

Skills

Relationship management

Contract negotiations

Customer service

Analytical skills

Education

Bachelor's degree

Tools

MS Excel

MS Word

Job description

EmblemHealth in New York seeks a Provider Relations Professional to build and optimize our network through strategic contracting, education, and issue resolution. You will serve as a liaison among facilities, professionals, and plan departments, driving contract load accuracy and program implementation.

Responsibilities include negotiating terms, overseeing quarterly renewals, analyzing financial impact, and coordinating with Claims, Care Management, and Credentialing to keep contracts compliant