Provider Contracting Director
Wisconsin
Job Description:
A health insurance company is seeking a Provider Contracting Director. The Provider Contracting Director will be responsible for implementing front-end contracting with providers and health systems, including the execution, negotiation and management of contracts. This is a relationship-based role that will have a high degree of visibility with providers in the marketplace. The director will deliver on the organization’s network and product expansion initiatives from a contracting perspective, including assessment of health system and provider partners, as well as membership utilization trends to garner the most favorable and compliant provider network structures. This is a retained search.
Responsibilities:
- Conduct an annual effectiveness review of contracting strategies.
- Ensure compliance with all contracting regulations and requirements.
- Oversee provider recruitment and implementation of contracts.
- Hold responsibility for contracts and testing, initiating setup, overseeing post-configuration testing, and maintaining and auditing the configuration within the claims system.
- Establish and maintain contract templates with contract language.
- Administer provider contracts, terms and reimbursement rates in a manner that complies with company policies and regulations.
Requirements:
- 5+ years of provider contract negotiation experience in the health insurance industry
- 5+ years of process leadership experience
- Managed care experience (preferred)
- Bachelor’s degree in a healthcare-related field or equivalent work experience; master’s degree or equivalent work experience (preferred)
Share this Job
-
Job At-A-Glance
-
Category Network Development and Contracting,Executive
Industry Health Plans
Type Executive Search
Location Wisconsin
Reference ID 35987
-
Similar Jobs
- Contact
Us
-
The Jacobson Group
190 South LaSalle Street, Suite 2850
Chicago, IL 60603 | USA
+ 1 (800) 466-1578
-