The Provider Network Manager is responsible for developing and retaining business and providing ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
The Provider Network Manager is responsible for developing and retaining business and providing ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
Provider Network Manager - Tampa
Miami, FL · On-site
$80K - $85K/yr
The Provider Network Manager is responsible for developing and retaining business and providing ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
Quick apply
Provider Network Manager - Tampa
Miami, FL · On-site
$80K - $85K/yr
The Provider Network Manager is responsible for developing and retaining business and providing ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
POSITION SUMMARY The Provider Network Manager is responsible for developing and retaining business ... contract agreement (care). * Bilingual in Spanish preferred * 5 years Medicare Advantage Plan.
PROVIDER NETWORK MANAGER POSITION SUMMARY: The Provider Network Manager is responsible for ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
PROVIDER NETWORK MANAGER POSITION SUMMARY: The Provider Network Manager is responsible for ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
Provider Network Manager - Orange County
Miami, FL · On-site
$80K - $85K/yr
PROVIDER NETWORK MANAGER POSITION SUMMARY: The Provider Network Manager is responsible for ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
Quick apply
Provider Network Manager - Orange County
Miami, FL · On-site
$80K - $85K/yr
PROVIDER NETWORK MANAGER POSITION SUMMARY: The Provider Network Manager is responsible for ... contract agreement (care). • Bilingual in Spanish preferred • 5 years Medicare Advantage Plan ...
Health Plan Provider Contracts Manager - Complex
Orlando, FL · On-site
$73.10K - $171.06K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
Orlando, FL · On-site
$73.10K - $171.06K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
Orlando, FL · On-site
$73.10K - $142.55K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
Orlando, FL · On-site
$73.10K - $142.55K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
$73.10K - $171.06K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
$73.10K - $171.06K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
$73.10K - $142.55K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
$73.10K - $142.55K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
Miami, FL · On-site
$73.10K - $142.55K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
Miami, FL · On-site
$73.10K - $142.55K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
$73.10K - $171.06K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
Health Plan Provider Contracts Manager - Complex
$73.10K - $171.06K/yr
... Molina's network adequacy standards. Assesses contract language for compliance with corporate ... Working familiarity with various managed health care provider compensation methodologies, primarily ...
CONTRACT MANAGER
Tallahassee, FL · On-site
$50K - $55K/yr
Analyze plan and provider issues/complaints, identify trends, and collaborate with plans to ... Contract/grant management experience and/or contract management certification. * Experience in the ...
Quick apply
CONTRACT MANAGER
Tallahassee, FL · On-site
$50K - $55K/yr
Analyze plan and provider issues/complaints, identify trends, and collaborate with plans to ... Contract/grant management experience and/or contract management certification. * Experience in the ...
Manager, Hospital Health Plan Provider Contracts (Florida)
Destin, FL · On-site
$80.80K - $108K/yr
Advises network provider contract specialists on negotiation of individual provider and routine ... Participates on the management team and other committees addressing the strategic goals of the ...
Manager, Hospital Health Plan Provider Contracts (Florida)
Destin, FL · On-site
$80.80K - $108K/yr
Advises network provider contract specialists on negotiation of individual provider and routine ... Participates on the management team and other committees addressing the strategic goals of the ...
Manager, Hospital Health Plan Provider Contracts (Florida)
Jacksonville, FL · On-site
$82.50K - $110.30K/yr
Advises network provider contract specialists on negotiation of individual provider and routine ... Participates on the management team and other committees addressing the strategic goals of the ...
Manager, Hospital Health Plan Provider Contracts (Florida)
Jacksonville, FL · On-site
$82.50K - $110.30K/yr
Advises network provider contract specialists on negotiation of individual provider and routine ... Participates on the management team and other committees addressing the strategic goals of the ...
Manager, Hospital Health Plan Provider Contracts (Florida)
Tampa, FL · On-site
$84.10K - $112.50K/yr
Advises network provider contract specialists on negotiation of individual provider and routine ... Participates on the management team and other committees addressing the strategic goals of the ...
Manager, Hospital Health Plan Provider Contracts (Florida)
Tampa, FL · On-site
$84.10K - $112.50K/yr
Advises network provider contract specialists on negotiation of individual provider and routine ... Participates on the management team and other committees addressing the strategic goals of the ...
Provider Network Contract Manager information
What are the key skills and qualifications needed to thrive as a Provider Network Contract Manager, and why are they important?
To thrive as a Provider Network Contract Manager, you need expertise in healthcare contract negotiation, provider relations, and a solid understanding of insurance regulations, generally supported by a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, data analysis tools, and knowledge of healthcare reimbursement systems is typically required. Strong communication, problem-solving, and relationship-building skills set top performers apart in this role. These abilities are crucial for building effective networks, ensuring compliance, and achieving cost-effective, high-quality care partnerships.
What are some typical challenges faced by a Provider Network Contract Manager when negotiating contracts with healthcare providers?
A Provider Network Contract Manager often encounters challenges such as aligning payer and provider expectations, managing rate negotiations, and ensuring contract compliance with regulatory requirements. Balancing the need for competitive reimbursement rates while maintaining strong provider relationships can be complex, especially in markets with limited provider options. Additionally, contract managers must frequently collaborate with legal, finance, and clinical teams to address operational impacts and resolve disputes, making strong communication and negotiation skills essential.
What is a Provider Network Contract Manager?
A Provider Network Contract Manager is a professional responsible for negotiating, developing, and managing contracts with healthcare providers such as hospitals, physicians, and clinics on behalf of insurance companies or healthcare organizations. Their main goal is to ensure that a network of providers delivers quality care to members at cost-effective rates. They also monitor contract compliance, analyze provider performance, and address any issues that may arise between providers and the organization. This role requires strong negotiation, communication, and analytical skills.
What is the difference between Provider Network Contract Manager vs Provider Contract Specialist?
| Aspect | Provider Network Contract Manager | Provider Contract Specialist |
|---|---|---|
| Credentials | Typically requires a bachelor's degree in healthcare administration, business, or related field; certifications like CPC or CPMSM are common | Similar credentials, often with healthcare or business background; certifications may include CPC or related |
| Work Environment | Works within healthcare organizations or insurance companies, managing network contracts and negotiations | Works in healthcare or insurance settings, focusing on contract review, processing, and compliance |
| Employer & Industry Usage | Used by health plans, provider networks, and insurance companies to manage provider agreements | Commonly employed in healthcare organizations and insurance firms for contract administration |
The Provider Network Contract Manager oversees the negotiation and management of provider agreements, focusing on network development. The Provider Contract Specialist handles contract processing and compliance. While both roles require similar credentials and work in related environments, the manager has a broader strategic focus, whereas the specialist concentrates on contract details and administration.
What are popular job titles related to Provider Network Contract Manager jobs in Florida? For Provider Network Contract Manager jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Provider Network Contract Manager jobs in Florida look for? The top searched job categories for Provider Network Contract Manager jobs in Florida are:
What cities in Florida are hiring for Provider Network Contract Manager jobs? Cities in Florida with the most Provider Network Contract Manager job openings:
Other
Medical, Dental, Vision, Retirement
This job post has expired today. Applications are no longer accepted.
Job description
About us:
Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued.Please check out our company website at www.solishealthplans.com to learn more about us!
*Candidates must be local to Tampa*
**BILINGUAL - ENGLISH & SPANISH IS REQUIRED**
POSITION SUMMARY:
The Provider Network Manager is responsible for developing and retaining business and providing excellent service to clients in the specified geographic region. The ideal person will have proven experience building on existing relationships, eliminating competitive threats within our network base, and ensuring satisfaction within our accounts.
ESSENTIAL DUTIES AND RESPONSIBILTIES:
• Generates and develops new business to meet specified production goals.
• Maintains and nurtures existing client relationships.
• Responds to all inquiries and requests in a timely and professional manner.
• Functions as liaison between client companies and operations staff.
• Understands and communicates information regarding company products, services, and policies and procedures to new and existing clients.
• Possesses and maintains thorough knowledge of Medicare Advantage Plan product information.
• Continually gathers information on local competition and prevalent industry and business climate within the region; communicates information to management and others as needed.
• Works with more complex providers. Complex providers may include, but are not limited to large institutional providers, and large medical groups, value-based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required.
• Conducts more complex negotiations and drafts documents.
• Ensures that all required client paperwork is complete, accurate, and submitted on time.
• Provides timely and accurate reports as required.
• Strong background in value based/full risk PCP MSO/IPA arrangements related to Medicare Advantage and other governmental programs.
• Attends and participates in business/trade events that impact business unit.
• Attends and participates in team strategic sales meetings.
• Performs other related duties as assigned by management.
QUALIFICATIONS & EDUCATION:
• Bachelor's degree (B. A.) or equivalent, 6 years of experience, or equivalent combination of education and experience.
• 5 years of experience in value based contract agreement (care).
• Bilingual in Spanish preferred
• 5 years Medicare Advantage Plan.
• Provider Network experience.
• Must be a self-starter and proactive.
• Commitment to excellence and high standards.
• Excellent written and verbal communication skills.
• Good judgement with the ability to make timely and sound decisions.
• Creative, flexible, and innovative team player.
• Demonstrated ability to make successful presentations to individuals and/or groups at all levels of an organization.
• Strong organizational skills; able to manage priorities and workflow.
• Ability to work independently and as a member of various teams and committees.
• Ability to calculate figures and amounts such as discounts, interest, commissions, and percentages.
• Excellent problem resolution and consultative sales skills.
• Proven ability to handle multiple projects and meet deadlines
• Strong interpersonal skills.
• Ability to prepare reports and business correspondence.
• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
What set us apart:
Join Solis Health Plans as a Provider Network Manager and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
JOIN OUR RAPIDLY GROWING TEAM! Our company has doubled in size, and we've grown our membership from 2,000 to over 10,000 members-and we're just getting started!
Benefits include (starting the first of the month following your hire date):
Be part of something big. Join our winning Solis Team today!
Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued.Please check out our company website at www.solishealthplans.com to learn more about us!
*Candidates must be local to Tampa*
**BILINGUAL - ENGLISH & SPANISH IS REQUIRED**
POSITION SUMMARY:
The Provider Network Manager is responsible for developing and retaining business and providing excellent service to clients in the specified geographic region. The ideal person will have proven experience building on existing relationships, eliminating competitive threats within our network base, and ensuring satisfaction within our accounts.
ESSENTIAL DUTIES AND RESPONSIBILTIES:
• Generates and develops new business to meet specified production goals.
• Maintains and nurtures existing client relationships.
• Responds to all inquiries and requests in a timely and professional manner.
• Functions as liaison between client companies and operations staff.
• Understands and communicates information regarding company products, services, and policies and procedures to new and existing clients.
• Possesses and maintains thorough knowledge of Medicare Advantage Plan product information.
• Continually gathers information on local competition and prevalent industry and business climate within the region; communicates information to management and others as needed.
• Works with more complex providers. Complex providers may include, but are not limited to large institutional providers, and large medical groups, value-based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required.
• Conducts more complex negotiations and drafts documents.
• Ensures that all required client paperwork is complete, accurate, and submitted on time.
• Provides timely and accurate reports as required.
• Strong background in value based/full risk PCP MSO/IPA arrangements related to Medicare Advantage and other governmental programs.
• Attends and participates in business/trade events that impact business unit.
• Attends and participates in team strategic sales meetings.
• Performs other related duties as assigned by management.
QUALIFICATIONS & EDUCATION:
• Bachelor's degree (B. A.) or equivalent, 6 years of experience, or equivalent combination of education and experience.
• 5 years of experience in value based contract agreement (care).
• Bilingual in Spanish preferred
• 5 years Medicare Advantage Plan.
• Provider Network experience.
• Must be a self-starter and proactive.
• Commitment to excellence and high standards.
• Excellent written and verbal communication skills.
• Good judgement with the ability to make timely and sound decisions.
• Creative, flexible, and innovative team player.
• Demonstrated ability to make successful presentations to individuals and/or groups at all levels of an organization.
• Strong organizational skills; able to manage priorities and workflow.
• Ability to work independently and as a member of various teams and committees.
• Ability to calculate figures and amounts such as discounts, interest, commissions, and percentages.
• Excellent problem resolution and consultative sales skills.
• Proven ability to handle multiple projects and meet deadlines
• Strong interpersonal skills.
• Ability to prepare reports and business correspondence.
• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
What set us apart:
Join Solis Health Plans as a Provider Network Manager and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
JOIN OUR RAPIDLY GROWING TEAM! Our company has doubled in size, and we've grown our membership from 2,000 to over 10,000 members-and we're just getting started!
Benefits include (starting the first of the month following your hire date):
- Medical, Dental, and Vision Insurance
- 401(k) plan with 100% company match
Be part of something big. Join our winning Solis Team today!
About Solis Health Plans
Sourced by ZipRecruiter
Industry
Insurance services
Company size
11 - 50 Employees
Headquarters location
Doral, FL, US
Year founded
2015