CareCentrix

  • Provider Network Contract Manager I

    Job Locations US-CT-Hartford
    Job ID
    2018-6185
    Category
    Provider/Network Management
  • Overview

    Network Contract Managers drive 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 CCX's profitability (and resulting EBITDA). Serving as the face of CCX 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 CCX network providers (our key asset) as a client.

    Responsibilities

    • 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
    • Collaborates and works well within both the Network Management team and other departments.
    • Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills.
    • Manage multiple tasks, be detail oriented, be responsive, and demonstrate independent thought and critical thinking.
    • Responsible to address network leakage concerns for all clients.

    Qualifications

    • Bachelor's Degree with two or more years of experience or 4+ years of direct healthcare experience in provider contract or relationship management required.
    • Must be familiar with modern office equipment and must be highly proficient in Microsoft Office.
    • Requires rigorous critical thinking and independent judgment.


    CareCentrix maintains a drug-free workplace in accordance with Florida's Drug Free Workplace Law.

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed