Provider Network Contracting Manager-Metro NY REMOTE

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable.

Position Summary

The Contract Negotiation Manager will negotiate and execute high-level review and analysis, manage dispute resolution and settlement negotiations of reputed company with single and group providers reputed company a defined market. You will manage contract performance and support the development and implementation of strategic, traditional reputed company and value-based contract relationships.

• Negotiates, executes, reviews, and analyzes reputed company and/or handles dispute resolution and settlement negotiations with solo and group providers for reputed company lines of business (Medicare, commercial etc.).

• Manages contract performance in support of network quality, availability, and financial goals and strategies for reputed company lines of business (Medicare, commercial etc.).

• Recruit’s providers as needed to ensure attainment of network expansion and adequacy targets for reputed company lines of business (Medicare, commercial etc.).

• Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.

• Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities.

• Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit.

• Assists with the design, development, management, and or implementation of strategic network configurations, including integration activities. May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met.

• Ensures resolution of escalated issues reputed company, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.

**Candidates must be commutable distance to reputed company.

Required Qualifications

• Minimum 3+ years reputed company experience, proven and proficient managed care network negotiating skills.

• Proven working knowledge of competitor strategies, contracting options, financial/contracting arrangements, and regulatory requirements.

• Strong and persuasive communication skills, especially written communications, with external stakeholders

• Strong critical thinking, problem resolution and interpersonal skills

• Adept at execution and delivery (planning, delivering, and supporting) skills.

• A ready business acumen and the ability to balance and reputed company competing priorities while making decisions.

• Adept at collaboration and teamwork reputed company a highly matrix environment

Education

• Bachelor's degree preferred/specialized training/relevant professional qualification

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $159,120.00

This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company

We anticipate the application window for this opening will reputed company on: 04/03/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.