Senior Provider Network Manager

• Develop the provider network through contract negotiations, relationship development, and servicing
• Focus on contracting and negotiating contract terms
• Work with complex providers, including large institutional providers, large medical groups, and ancillary providers
• Support value-based concepts
• Serve as a key resource for contracting staff
• Provide mentoring and on-the-job training and development
• Work independently using judgment and discretion
• Work on projects impacting the business unit in collaboration with other key areas
• Serve on enterprise projects around network management
• Serve as a communication link between professional providers and the company
• Ensure appropriate distribution of provider specialties in the network
• Conduct complex negotiations and draft documents
• Prepare financial projections and conduct analysis
• Travel to worksites and other locations as necessary

• Requires a BA/BS degree
• Minimum of 5 years of experience in contracting, provider relations, provider servicing
• Experience should include prior contracting experience
• Any combination of education and experience providing an equivalent background may be considered
• Experience in fee schedule development using actuarial models strongly preferred
• Strong project management skills
• Comprehensive negotiation skills supporting multi-service lines of business
• Candidates must reside within a reasonable commuting distance from the posting location(s), unless accommodation is granted as required by law
• Ability to work Monday-Friday, 40 hours per week, either 8:00 am-5:00 pm or 9:00 am-6:00 pm
• New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided

Demonstrates expertise in contract negotiations and provider relations, with a strong focus on developing provider networks and supporting value-based concepts. Proven ability to mentor and train staff while managing complex projects and conducting financial analysis.

• Contract Negotiation
• Provider Relations
• Project Management
• Financial Analysis
• Mentoring and Training

• Contracting
• Fee Schedule Development
• Actuarial Models
• Negotiation Skills
• Financial Projections

• Relationship Development
• Judgment and Discretion
• Communication Skills

• BA/BS Degree

• Provider Network
• Value-Based Concepts
• Multi-Service Lines
• Provider Specialties
• Provider Servicing