Highmark Health Senior Provider Contracting Consultant-2 in Raleigh, North Carolina

Description

I. GENERAL OVERVIEW:

Serve in a leadership role for all activities and develop strategies for contract negotiations that support departmental initiatives as well as Highmark’s corporate mission and objectives.

II. ESSENTIAL RESPONSIBILITIES:

  1. Lead negotiations of provider payment and contractual terms, with responsibility for the development and execution of work plans and strategy for provider contracting initiatives.

  2. Represent Provider Contracts for network provider contractual and/or reimbursement related concerns both internally and externally.

  3. Mentor a team of Provider Contract Specialists in the development and assessment of pricing proposals and provider profile information for contract negotiations.

  4. Develop and maintain positive, effective provider relationships.

  5. Support the management and development of Provider Contract Specialists.

  6. Ensure compliance with contractual terms.

  7. Other duties as assigned or requested.

III. QUALIFICATIONS:

Education, Licenses/Certifications, and Experience

Minimum

• Bachelors Degree

• 5-7 years of experience required in health care delivery system to include health insurance and managed care product administration.

• 3-5 years of experience in provider contract negotiations.

Preferred

• Bachelors Degree in Business, Finance or Health Service Administration

• MBA, MHA credentials

Knowledge, Skills and Abilities

• Experience with Microsoft products with profiency with Excel and PowerPoint

• Strong written communication skills

• Strong interpersonal and presentation skills

IV. SCOPE OF RESPONSIBILITY

Does this role supervise/manage other employees? No X Yes □

V. WORK ENVIRONMENT

Is Travel Required?

No □ Yes X

This job requires the ability to work as a team member. Additionally, this job requires the willingness and ability to report to work on a regular and timely basis and may require irregular work hours, holidays and/or weekends.

REQNUMBER: J127204

Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity