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Provider Network Contractor

Ewings Associates in Tulsa, OK, USA

EWINGS is in search of Healthcare Provider Network professionals for a 10-12 month telecommute assignment supporting our client Optum in their efforts to build provider networks across 38 states for the Department of Veteran Affairs.

Assignments are starting soon!

POSITION DESCRIPTION: Healthcare Provider Network Contractor - Develop a provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance, trend management, and produces an affordable and predictable product for customers and business partners. Provider network contractor will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining relationships with providers ensuring the network composition includes an appropriate distribution of provider specialties.

REQUIREMENTS: 2+ years of experience in a network management-related role, such as contracting or provider services. Managed care work experience contracting or recruiting a range of healthcare providers including physicians, hospitals, specialists, ancillaries. Knowledge of reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) preferred. At least an intermediate level of knowledge of claims processing systems and guidelines. Intermediate level of experience with MS Excel required. Excellent verbal and written communication skills.

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Posted date: 12 days ago

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