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Provider Contract Jobs in Kentucky (NOW HIRING)

Baptist Health

Contract Manager

Louisville, KY · On-site

$85K - $114K/yr

The Contract Manager is responsible for leading system wide contracting of supplies, equipment ... The manager is responsible for providing high quality, efficient, and cost-effective service to the ...

Baptist Health

Contract Manager

Louisville, KY · On-site

$85K - $114K/yr

The Contract Manager is responsible for leading system wide contracting of supplies, equipment ... The manager is responsible for providing high quality, efficient, and cost-effective service to the ...

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Provider Contract information

What is a provider contract?

A provider contract is a formal agreement between a healthcare provider, such as a doctor or hospital, and a health insurance company or managed care organization. This contract outlines the terms under which the provider will deliver medical services to insured members, including reimbursement rates, covered services, and billing procedures. Provider contracts help ensure that patients receive agreed-upon care at predetermined costs and establish the responsibilities of both the provider and the insurer. These agreements are essential for maintaining a network of healthcare professionals who serve plan members.

What are the key skills and qualifications needed to thrive as a provider contract specialist, and why are they important?

To excel as a Provider Contract Specialist, you need strong analytical abilities, knowledge of healthcare regulations, contract negotiation skills, and typically a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, healthcare reimbursement systems, and proficiency in Microsoft Office are commonly required. Excellent attention to detail, communication, and relationship-building skills help you collaborate effectively with providers and internal stakeholders. These competencies ensure accurate contract execution, regulatory compliance, and mutually beneficial agreements in a complex healthcare environment.

What are some common challenges faced by professionals in provider contract roles, and how can they be addressed?

Professionals in provider contract roles often encounter challenges such as navigating complex regulatory requirements, ensuring contract compliance, and balancing the interests of both healthcare providers and payers. Additionally, they may need to negotiate terms that are both competitive and sustainable for their organization. These challenges can be addressed by staying up-to-date with industry regulations, developing strong negotiation and communication skills, and fostering collaborative relationships with internal legal, compliance, and finance teams.

What is the difference between Provider Contract vs Medical Billing Specialist?

AspectProvider ContractMedical Billing Specialist
CredentialsTypically requires healthcare administration, legal, or business certificationsRequires coding, billing, and healthcare reimbursement certifications
Work EnvironmentHealthcare facilities, insurance companies, or legal officesMedical offices, billing companies, or healthcare providers
Industry UsageUsed in healthcare contracting, negotiations, and legal agreementsUsed in processing insurance claims and patient billing

While Provider Contract specialists focus on creating and managing agreements between healthcare providers and payers, Medical Billing Specialists handle the coding and submission of claims for reimbursement. Both roles are essential in healthcare finance but serve different functions within the revenue cycle.

What cities in Kentucky are hiring for Provider Contract jobs?

Cities in Kentucky with the most Provider Contract job openings:

Provider Contract jobs near you

Senior Provider Contract Analyst, NMG Finance, Days

Norton Healthcare

Louisville, KY • On-site

$78K - $97K/yr

Full-time

Posted 15 days ago

Norton Healthcare rating

7.4

Company rating: 7.4 out of 10

Based on 187 frontline employees who took The Breakroom Quiz

268th of 887 rated healthcare providers

Job description

Responsibilities
The Senior Provider Contract Analyst-NMG works closely with the Director Provider Contracts-NMG to ensure provider employment agreement terms and physician compensation is accurate, timely, and in compliance with contracted expectations. As a Senior Provider Contract Analyst-NMG, you will have the opportunity to learn about a niche specialty area that is growing in the marketplace. In this role, you will work closely with other members of the team day-to-day. You will learn about the valuation of physician compensation and healthcare clinical financial operations. Specific tasks include financial modeling of physician compensation, documenting for compliance management purposes and collaborating to foster working relationships with stake holders. This position will interact with all members of the contracts team as well as with other departments as related to compensation research or regular data sharing. This position performs a variety of project-oriented tasks to support the development and implementation of projects, initiatives and compliance with Stark, Anti-Kickback and FMV regulations.
Qualifications
Required:
  • Three years of experience in accounting, finance or data analytics.
  • Bachelor Degree

Desired:
  • Experience administering physician compensation programs including productivity bonuses. Strong understanding of Stark, Anti-Kickback Statute, FMV concepts and competitive market benchmarking.

What Norton Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Norton Healthcare

Sourced by ZipRecruiter

Norton Healthcare is a not-for-profit hospital and health care system and is Louisville's second largest employer, with more than 18,000 employees, over 1,700 employed medical providers and approximately 2,000 total physicians on its medical staff. The system includes six hospitals (five in Louisville and one in Madison, Indiana) with 1,993 licensed beds, eight outpatient centers, 18 Norton Immediate Care Centers, eight Norton Prompt Care at Walgreens clinics and an expanded telehealth program. It provides care at more than 340 locations throughout Kentucky and Southern Indiana.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1988

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