Provider Network Rep
Cincinnati, OH · On-site
Everything in bold was added by the hiring manager** Position Purpose: Perform duties to act as a ... network and assist with claim resolution. Serve as primary contact for providers and act as a ...
Provider Network Rep
Cincinnati, OH · On-site
Everything in bold was added by the hiring manager** Position Purpose: Perform duties to act as a ... network and assist with claim resolution. Serve as primary contact for providers and act as a ...
Provides executive direction and oversight for complex, high-impact provider contract negotiations ... provider network management processes and best practices. • Strong knowledge of health plan ...
Provides executive direction and oversight for complex, high-impact provider contract negotiations ... provider network management processes and best practices. • Strong knowledge of health plan ...
Contract Manager
Cincinnati, OH · On-site
$85K - $114K/yr
Provide mentorship and guidance to contract specialists and junior managers Qualifications * Bachelor's degree in a related field of study; * 3+ years of contract drafting, redlining, and negotiation ...
Contract Manager
Cincinnati, OH · On-site
$85K - $114K/yr
Provide mentorship and guidance to contract specialists and junior managers Qualifications * Bachelor's degree in a related field of study; * 3+ years of contract drafting, redlining, and negotiation ...
Contract Manager
Cincinnati, OH · On-site +1
$85K - $114K/yr
Provide mentorship and guidance to contract specialists and junior managers Qualifications * Bachelor's degree in a related field of study; * 3+ years of contract drafting, redlining, and negotiation ...
Contract Manager
Cincinnati, OH · On-site +1
$85K - $114K/yr
Provide mentorship and guidance to contract specialists and junior managers Qualifications * Bachelor's degree in a related field of study; * 3+ years of contract drafting, redlining, and negotiation ...
CORP H&W/CONTRACT MANAGER
Cincinnati, OH · On-site
$86K - $116K/yr
Contract with accounts by negotiating network rate, guarantees, contract language, services, and ... Serve as SME with regard to contracts they have been assigned providing information to internal ...
CORP H&W/CONTRACT MANAGER
Cincinnati, OH · On-site
$86K - $116K/yr
Contract with accounts by negotiating network rate, guarantees, contract language, services, and ... Serve as SME with regard to contracts they have been assigned providing information to internal ...
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Mason, OH · Hybrid
$111K - $166K/yr
Acts as the primary contract resource for internal teams; provides contract education to support ... network participation inquiries. Minimum Requirements: Requires a Bachelor's degree in Business ...
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Mason, OH · Hybrid
$111K - $166K/yr
Acts as the primary contract resource for internal teams; provides contract education to support ... network participation inquiries. Minimum Requirements: Requires a Bachelor's degree in Business ...
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Manages contract performance in support of network quality, availability, and financial goals and ... Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Mason, OH · Hybrid
$111K - $166K/yr
Acts as the primary contract resource for internal teams; provides contract education to support ... network participation inquiries. Minimum Requirements: Requires a Bachelor's degree in Business ...
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Mason, OH · Hybrid
$111K - $166K/yr
Acts as the primary contract resource for internal teams; provides contract education to support ... network participation inquiries. Minimum Requirements: Requires a Bachelor's degree in Business ...
Provide technical guidance to support team when required. * Enforce use of engineering standards. * Contributes to development of tools that facilitate contract management. * Demonstrates excellent ...
Provide technical guidance to support team when required. * Enforce use of engineering standards. * Contributes to development of tools that facilitate contract management. * Demonstrates excellent ...
Provider Network Contract Manager information
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 are the key skills and qualifications needed to thrive as a provider network contract manager?
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 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 Ohio?
For Provider Network Contract Manager jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Provider Network Contract Manager jobs in Ohio look for?
The top searched job categories for Provider Network Contract Manager jobs in Ohio are:
What cities in Ohio are hiring for Provider Network Contract Manager jobs?
Cities in Ohio with the most Provider Network Contract Manager job openings:
Full-time
Medical, Retirement
Re-posted 29 days ago
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
This person will be a primary contact for providers. They will schedule, organize and facilitate collaborative JOC meetings as needed. They will perform provider orientations for individual providers and large provider groups. They will also provide ongoing education for these providers. They will travel to provider's offices, so they must have a driver's license.
**Everything in bold was added by the hiring manager**
Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution.
Serve as primary contact for providers and act as a liaison between the home and community based services providers and the health plan
Conduct monthly face-to-face meetings with the provider account representatives documenting discussions, issues, attendees, action items, and research claims issues on-site, where possible, and route to the appropriate party for resolute
Schedule, organize and facilitate collaborative JOC meetings as needed.
Receive and effectively respond to external provider related issues
Provide education on health plan's innovative contracting strategies
Initiate data entry of provider-related demographic information changes and oversee testing and completion of change requests for the network
Investigate, resolve and communicate provider claim issues and changes
Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation, MMP updates and related topics
Perform provider orientations for individuals, large diverse provider groups and ongoing provider education for same, including writing and updating orientation materials which you will present.
Ability to travel
Qualifications
Requirements:
- bachelor's degree or equivalent experience
- Ohio driver's license
- 1+ years of provider relations or contracting experience
- familiarity with JOC meetings (Joint operating committee meetings) - ability to schedule and organize (these are meetings between providers and the health plan to educate providers and inform them of changes, etc)
- experience acting as a liaison between health plans and providers (can come from the provider side)
Hours for this Position:
M-F 8-5
Advantages of this Opportunity:
- Competitive salary
- Fun and positive work environment
- Room for growth
- Medical benefits 1st of the month after hire
- 401k Matching
Additional Information
Interested in being considered?
If you are interested in being considered for the position, please contact Ashley Greene at 407-478-0332 ext 169.
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003