Provider Contracts Specialist

Job Summary

Managing provider contracts, the full-time Provider Contracts Specialist will coordinate pricing arrangements and develop standard contracts for provider groups and facilities within the Health Plan networks, while working remotely.

Key responsibilities

• Evaluate and negotiate contracts with physicians, ancillary providers, and hospitals, including reimbursement methodologies
• Prepare accurate agreements and collaborate with team analysts to ensure proper implementation in company systems
• Assist in provider recruitment, network education, and maintaining relationships within the Health Plan service area

Required qualifications

• Bachelor's degree or equivalent experience in finance, business, health care administration, or communications preferred
• Prior experience in health care insurance or insurance network management
• Experience with analyzing and negotiating contract terms and reimbursement rates
• Proficiency in contract reading, redlining, and MS Office applications
• Willingness to travel occasionally for meetings and conferences