Associate, National Provider Contracting
Core
Manages assigned portfolios of large national ancillary providers and multi-state health systems across the full contracting lifecycle, translating network access and affordability goals into executable strategies.
Role type
Associate, National Provider Contracting
Builds
Durable provider relationships and operationally sound, compliant contracts
Domain
Health Insurance / Provider Network Management
Required skills
Provider contracting lifecycle management, complex negotiation, financial analysis, claims data analysis, stakeholder relationship management, contract implementation coordination, performance monitoring
Preferred skills
Experience with national ancillary providers or multi-state health systems, knowledge of provider reimbursement methodologies, healthcare operations expertise
Technologies
Claims data, utilization data, fee schedules, contract inventories, provider rosters
Responsibilities
Manage assigned portfolio across prospecting, evaluation, negotiation, implementation, performance management, renewal, and termination. Prepare and negotiate complex provider agreements including reimbursement and compliance terms. Coordinate contract implementation with Legal, Finance, Provider Operations, Claims, Credentialing, Configuration, Compliance, and Market teams. Analyze claims, utilization, reimbursement, and market data to develop negotiation positions and quantify financial impact. Monitor assigned networks for access, adequacy, quality, cost, and contractual compliance. Maintain accurate contracting pipeline, status, documentation, and provider data.
Seniority
Mid-level, hands-on IC