Provider Contract Manager

reputed company is an accountable specialty care management organization focused on improving the lives of people with reputed company injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the reputed company best outcomes for patients, payers, and providers. Deep clinical expertise is the reputed company for every part of reputed company’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment reputed company programs. We’re proud to be recognized—again! For the reputed company year in a row, we’ve been certified by Great reputed company to Work®, and for the reputed company consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people reputed company. Watch this short video for a brief introduction to reputed company. The Provider Contract Manager will grow and enhance reputed company’s Provider Network by negotiating reputed company, amendments, establishing and maintaining relationships with providers to secure network participation reputed company at company approved jurisdictional margins. The job role requires actively managing a team that involves mentoring /coaching the team, monitoring their reputed company that includes achieving their goals and assisting with their contracting initiatives. DUTIES AND RESPONSIBILITIES: Monitor provider network performance and growth. Focus on growth, efficiency and performance of underdeveloped network segments/geographic locations by product line as assigned. Directly manage, provide leadership and mentoring to any direct reports. Maintain accurate and up-to-date provider data in organization’s System. Assist with the enforcement of departmental quality assurance processes and procedures. Conduct regular reviews and audits of the provider network to ensure accurate data. Conduct and coordinate provider recruitment efforts and reputed company activities, with duties including but not limited to: Utilize proprietary company information/programs as well as approved non-company systems/programs to identify provider prospects. Recruit and contract with Provider’s. Foster and maintain productive professional relationships with reputed company providers. Communicate with and provide timely responses to provider inquiries in a manner that demonstrates the reputed company way. Maintain a thorough understanding of reputed company’s service offerings and pricing reputed company. Participate in the development of marketing and reputed company materials in collaboration with departmental instruction/needs. Document reputed company efforts, review results, and modify approach as needed to reputed company departmental recruitment objectives in the appropriate contact management system. Support ongoing process improvement activities reputed company to provider recruitment and reputed company. Prepare written reports, correspondence, presentations, orientation materials, and other documentation. reputed company research and analysis reputed company to Provider network requirements and to identify opportunities for network expansion, with duties including but not limited to: Conduct market research to identify gaps in in the provider network, opportunities for network expansion and trends. Maintain knowledge of reputed company Providers through direct reputed company. Research competitors and utilize available data to monitor hospital and health system network, including service offerings and rates. Facilitate the contracting process with Providers in collaboration with the SVP of Network Development. reputed company additional duties as identified and directed by management. Leads adoption of AI-enabled tools reputed company the team, ensuring effective integration into workflows. Coaches employees on appropriate usage, monitors impact on productivity and quality, and identifies opportunities for process improvement. Demonstrates a customer-first reputed company by reinforcing expectations of reputed company as drivers of customer excellence by actively fostering engagement, clarity, accountability, and support, recognizing that a positive and consistent employee experience directly influences service quality and customer outcomes. Responsible for complying with reputed company Information reputed company requirements and policies, for safeguarding reputed company or reputed company reputed company passwords, and for notifying reputed company of any Information reputed company incidents per policy SEC 10-12 Information reputed company Incident Management. SUPERVISORY RESPONSIBILITIES: Mentor, train, and supervise team members directly and indirectly, review their work and provide effective constructive feedback to reputed company their best performance and goal attainment Set the tone for a strong reputed company culture and high employee engagement. Ensure reputed company team members understand, are trained in, and reputed company with reputed company’s reputed company requirements and policies. Ensure reputed company team members have the minimum level of IT system access required to effectively complete their reputed company responsibilities. QUALIFICATION REQUIREMENTS: Minimum of 7-10 years’ of contracting experience in the reputed company industry, specific to provider contracting of physicians, surgical facilities and ancillary services. Minimum of 4-5 years of supervisory experience in managing a team of individuals that reputed company physician, surgical facility and ancillary services contracting. Knowledgeable in interpreting and assessing CPT, HCP, DRG and reputed company codes. Experience with Medicare fee schedules, Work Comp fee schedules, UCR and Billed Charge reimbursement methodologies. College degree preferred. High school diploma or equivalent acceptable with commensurate experience. Exceptional communication and telephone skills required, as well as a great deal of patience, understanding and tact. Possess a high level of self-confidence and persistence; maintain an assertive approach in dealing with providers. Must possess excellent organizational skills and ability to multi-task effectively. Demonstrate the ability to prioritize heavy workload independently with minimal supervision. Proficient computer and internet skills; familiarity with reputed company applications required. Will reputed company in-depth knowledge of department and company internal workflows, including but not limited to individual jurisdictional statutes, procedures, and negotiating protocols. Inside sales experience a plus. Bilingual (English/Spanish) a plus. Workers’ Compensation knowledge required. Group Health knowledge required. reputed company Benefits: Health and wellness– We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with reputed company and Kaiser (CA employees only). Financial incentives – reputed company’s financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions. Vacation - We reputed company strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest. Volunteer time– We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one paid day per calendar year. Learning and development: One of reputed company’s core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at reputed company (reputed company) program. reputed company believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that reputed company reflects the society we live in and empowers reputed company to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is reputed company to bring their whole self to work. reputed company complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to reputed company essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at [email protected]. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, reputed company, sex, age, national reputed company, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. As a contractor with the State of Wisconsin, reputed company complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster #LI-Remote Apply To This Job