Manager, Provider Contract Negotiation (Georgia)
Core
Manages provider contract performance, drives value-based contract relationships, and executes cost-saving initiatives to meet network expansion and medical cost targets.
Role type
Manager, Provider Contract Negotiation
Builds
Provider network contracts and reimbursement models
Domain
Health insurance / Managed care
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Provider relations, Contracting, Managed care industry knowledge, Cost analysis, Network expansion, Cross-functional collaboration, Contract negotiation, Reimbursement modeling, Strategic planning, Issue resolution
Preferred skills
Physician/Ancillary/Commercial experience, Medicare program knowledge, Relationship building
Technologies
Internal data tools
Responsibilities
Manage contract performance and implement value-based relationships; Recruit providers to meet network expansion targets; Collaborate on provider compensation and pricing development; Identify and execute cost-saving initiatives; Evaluate and implement provider network strategic plans; Resolve escalated issues regarding claims payment and contract interpretation.
Seniority
Manager, hands-on leadership
