CareCentrix

Contract Manager - Provider Contracting and Management

Job Locations US-CT-Hartford | Remote | US-FL-Tampa
Job ID
2020-8903
Category
Provider Management

Overview

As the Contract Manager for Provider Contracting & Management, you will manage the provider network in an assigned state(s) or region for multiple payers. You will prepare, analyze, negotiate and maintain contracts for the provider network for the services that CareCentrix provides on behalf of its clients. You will be responsible for the development/fostering of relationships with Providers, ACO’s, Health Systems, Health Plans, including working cross-departmentally within CareCentrix and the client organizations to ensure high levels of client interaction and satisfaction.  You will also be responsible for participating in the development of the network management strategy which includes aspects of technology product, utilization management, value-based care, membership growth, marketing, compliance, and member and provider experience.

Responsibilities

In this role, you will:

  • Be the face of CareCentrix to the providers in the region.
  • Lead provider engagement strategies to build a high performing network that delivers high quality care at low costs.
  • Partner with departments including claims and UM teams to address operational issues raised by providers.
  • Execute on network build and provider contracting initiatives by engaging key providers throughout the designated region.
  • Partner with the Network leadership to identify and recruit providers into a value/risk-based performance contracts.
  • Ensure that the contract management strategy is developed and executed in line with payer arrangements.
  • Develop deeper partnerships with key target providers in the region.
  • Implement new programs and policies to improve value and outcomes of provider contracts.
  • Address and resolve operational challenges raised by network providers and effectively communicate those needs to internal stakeholders.

 

Why You Are Going to Love this Role and CareCentrix:

  • You love negotiations that result in a win-win for both parties.
  • You are passionate about fixing health care and believe that one of the best ways to do that is by helping improve the quality and access to care in the home.
  • You love to learn and are curious to understand the nuances of a situation.
  • You enjoy getting your hands dirty in operational weeds to help your customers address their needs.
  • You enjoy working with teams by building trust, fostering positive relationships and partnering with a diverse group of people.
  • You like to move fast. Living in the gray space does not slow you down.  You enjoy working through ambiguity and a changing market environment. 

Qualifications

You should get in touch if:

  • You have a Bachelor's Degree and 4+ years background in provider contracting or other B2B partnerships in other industries (maybe you managed coffee bean supply chains and understand how to source high v. low quality beans!).
  • You think in quantitative terms. You may even know a bit about financial modeling or SQL programming. 
  • You have a great understanding of healthcare topics, such as claims processing, EHRs, medical billing and value-based care.
  • You have some answers but not all of them. You know every healthcare problem is unique and approach problems with questions not answers.
  • You are fun to work with!  We take our commitment to patients seriously, but we don’t take ourselves seriously.  We are looking for team members who bring joy to the work they do.

 

CareCentrix maintains a drug-free workplace.

 

We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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