The Network Contract Specialist develops the provider network (physicians, hospitals, dental, ancillary groups and facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contract Specialist will evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process protocols. Responsibilities also include establishing and maintaining strong business relationships with physicians and ensuring the network composition includes an appropriate distribution of provider specialties.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
Undergraduate degree or equivalent experience
Paralegal or contract language background
Three (3) or more years of experience in a network management related role, such as contracting or provider services
Two (2) of experience in performing or reviewing network adequacy analysis
An intermediate level of knowledge of claims processing systems and guidelines
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand.