Senior Provider Contracting Specialist

Position: Senior Provider Contracting Specialist

Role Overview:

This advanced-level position is pivotal in establishing and nurturing strategic, creative, and data-driven partnerships with healthcare providers. The specialist will work autonomously to drive performance improvements, negotiate high-stake contracts, and maintain robust relationships with various healthcare stakeholders.

Key Responsibilities:

- Strategic Partnership Development: Foster a trusted environment with providers through relationship management, leveraging data to identify and act on collaboration opportunities that enhance performance metrics.

- Contract Negotiation and Management: Conduct evaluations and negotiations compliant with company standards and controls. Ensure contracts support value-based care objectives, focusing on risk-based agreements with integrated quality and cost measures.

- Relationship Maintenance: Sustain and deepen relationships with Hospital, Physician, Pharmacy, and Ancillary providers, ensuring a balanced network. Regularly engage with contracting peers and leaders to enhance collaboration and mutual benefits.

- Expertise and Advocacy: Serve as a subject matter expert on provider value-based programs, facilitating understanding and participation in the network. Develop solutions with cross-functional teams to optimize provider performance.

Qualifications:

- Bachelor’s degree or equivalent in a related field.

- 3+ years of post-degree experience in provider contracting, including expertise in value-based and total-cost-of-care arrangements.

- Strong understanding of ACOs and various contracting methodologies.

Skills and Abilities:

- Proven ability to negotiate and maintain significant provider contracts.

- Exceptional relationship-building and maintenance skills across all organizational levels, including senior leadership.

- Strong financial, analytical, and problem-solving skills.

- Excellent communication abilities, both written and verbal, capable of conveying complex information clearly and persuasively.

- Experience in contract interpretation, provider value-based financial analysis, and legal aspects of contracting.

- Demonstrated competency in managing projects to meet deadlines and organizational goals.

- Ability to facilitate information sharing and drive discussions within clinically integrated network teams.