Located in Richardson or Houston within Network Delivery - overseeing Commercial contract negotiations and provider relations activities for Behavioral Health Facilities and ambulatory surgery centers, freestanding ERs, cardiac cath labs, birthing centers, & diagnostic laboratories. Develop and negotiate contracts. Develop and maintain relationships with providers. Ensure strategic coverage for assigned territory. Responsible for education of providers and for ongoing provider service, responsible for managing daily activities and implementation of strategies for provider recruitment. Responsible for the management, mentoring and training of a team responsible for provider contracting and provider support resources. Provide subject matter expertise to improve efficiencies and results.
∗ Bachelor Degree and 4 years provider contracting experience OR a Master degree and 3 years contracting experience OR 8 years managed care experience including 4 years provider contracting experience. ***Contracting experience involves negotiating language, redlining, financial arrangements, and reimbursements/rates.
∗ Extensive knowledge of provider and facility contracting, products, and claims/processing systems.
* Negotiation experience with decision makers.
∗ Leadership skills to oversee staff, implement initiatives, and work across the company to resolve issues.
∗ Team Lead or experience managing full cycle project initiatives and resources.
∗ Relationship building skills.
∗ Knowledge of marketplace.
∗ Meet deadlines and work well under pressure.
∗ Verbal and written communication skills to interact with all levels of corporate personnel and providers.
∗ PC proficiency to include Microsoft Office.
∗ Analytical skills
∗ Project management skills to lead or participate in projects or initiatives.
∗ Ability and willingness to travel within assigned areas of responsibility, including overnight stays
*Experienced in Commercial Health Insurance (non-Gov't managed health) negotiations.
*Negotiations of behavioral health facilities, ambulatory surgery centers, freestanding ERs, cardiac cath labs, birthing centers, and diagnostic laboratories.
*Strong negotiation skills; assertive, influential, effective.
*Strong people management skills; hire, development, goals setting, performance management..
All the above requirements must be met to be considered for this role.
The position is located in Houston or Richardson, TX.
Sponsorship is not provided at this time.
Job ID: EMO-1030711