Description
We are seeking a Provider Contracting Specialist to join our team in Chicago, IL. This role is responsible for managing complex contracting and negotiations with hospitals and other providers, building relationships to support the local market strategy, and identifying opportunities for greater value-orientation and risk arrangements.
Responsibilities:
- Manage complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers
- Build relationships that nurture provider partnerships and seek broader value-based business opportunities
- Initiate and maintain effective channels of communication with matrix partners
- Manage strategic positioning for provider contracting, develop networks, and identify opportunities for greater value-orientation and risk arrangements
- Contribute to the development of alternative network initiatives and support network analytics
- Work to meet unit cost targets while preserving an adequate network
- Create and manage initiatives that improve total medical cost and quality
- Drive change with external provider partners by assessing clinical informatics and offering consultative expertise
- Prepare, analyze, review, and project financial impact of larger or complex provider contracts
- Create 'HCP' agreements that meet internal operational standards and external provider expectations
- Assist in resolving elevated and complex provider service complaints
- Manage key provider relationships and demonstrate knowledge of providers in an assigned geographic area
Requirements:
- Bachelor's degree in Finance, Economics, Healthcare, or Business-related field (significant industry experience will be considered in lieu of a Bachelor's degree)
- Minimum 3 years of contracting and negotiating experience involving complex delivery systems and organizations
- Experience in developing and managing key provider relationships
- Knowledge of complex reimbursement methodologies, including incentive-based models
- Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners
- Intimate understanding and experience with hospital, managed care, and provider business models
- Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization
- Strong written and verbal communication skills, with experience in formal presentations
- Customer-centric and interpersonal skills are required
- Demonstrates managerial courage and ability to maneuver effectively in a changing environment
- Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen
- Knowledge and use of Microsoft Office tools
Benefits:
- Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs
- 401(k) and company-paid life insurance
- Tuition reimbursement and a minimum of 18 days of paid time off per year
- Paid holidays and leaves of absence