Duties And Responsibilities

• Manages contract negotiations with physician groups. Conducting several negotiations simultaneously to meet growth demands. 
• Proactively builds relationships that nurture provider partnerships to support the local market strategy. 
• Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, Claims, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing. 
• Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position. 
• Identify and manages initiatives that improve total medical cost and quality. 
• Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. 
• Assists in resolving elevated provider service complaints. Research problems and negotiates with internal/external partners/customers to resolve complex and/or escalated issues. 
• Manages key provider relationships and is accountable for critical interface with providers and business staff. 
• Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape. 
• Partner with Regulatory Affairs to ensure all network filings are timely and accurate.
• Performs other duties as assigned

Position Requirements

• Bachelor’s degree or equivalent experience in related field, plus 5+ years of work experience beyond degree within provider contracting and/or health insurance 
• Experience with Physician group contracting and negotiations 
• Experience negotiating delegated credentialing agreements 
• Experience in developing and managing key provider relationships including senior executives 
• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners 
• Intimate understanding and experience with larger, more complex integrated delivery systems managed care, and provider business models 
• Team player with proven ability to develop strong working relationships within a fast-paced organization 
• The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations 
• Customer centric and interpersonal skills are required  Superior problem solving, decision-making, negotiating skills, contract language and financial acumen
• Remote with occasional travel (5%)
• Existing relationships with physician groups in Texas and/or Florida will be helpful