Come join a dynamic, growing team in an innovative, game-changing, healthcare organization! CareCentrix is committed to making the home the center of patient care.
As the Network Contract Manager you will be responsible for driving all aspects of provider network management for an assigned geographic area, typically comprised of various states. Not the typical Network Management role, the Managers function like P&L leaders as they have direct responsibility over gross margin which impacts CareCentrix profitability (and resulting EBITDA).
Serving as the face of CareCentrix to our providers, Managers negotiate contracts (rates & terms), drive in-network utilization by ensuring adequate provider depth (coverage area) and breadth (line of business), and ensure high levels of provider satisfaction by treating CareCentrix network providers (our key asset) as a client.
• Initiates, develops and manages provider contracts and senior-level provider relationships.
• Understands and knowledgeable of the contract templates, and applicable regulations surrounding network administration and claims payments.
• Understand and knowledgeable of individual provider contracts
• Monitors and documents contract compliance via metrics to to ensure delivery of agreed upon terms by the provider to CareCentrix
• Monitors, identifies, escalates, and takes action on identified deficiencies in contract performance and takes action to correct any gaps / deficiencies in quality or financial performance.
• Build a deep localized knowledge base to inform strategic planning.
• Build strong relationships with providers to ensure lines of communications are open and strong.
• Leverages market and service expertise to inform strategic initiatives, new product launches and provider-based partnerships.
• Participates in strategic and tactical initiatives led by the Network Management department
• Bachelor's Degree with a minimum 2 years of direct healthcare experience in provider contract or relationship management required.
• Highly proficient in Microsoft Office.
• Requires rigorous critical thinking and independent judgment