Senior Manager, Contract Negotiation Manager

This position supports Provider Contracting and Relationship Management for the Commercial and Medicare Segments with large and small health systems.

• Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost incentives

• Manages contract performance in support of network quality, availability, and financial goals and strategies

• Recruit providers as needed to ensure attainment of network expansion and adequacy targets

• Collaborates cross -functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities

• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.

• Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities

• Provides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unit

• Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities

• Optimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are met

• Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic information

• Coaches more junior colleagues in techniques, processes, and responsibilities.

Required Qualifications:

• 7+ years of Healthcare industry experience

• 5+ years of Provider Contract Network and Negotiation experience preferably.

• Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements

• 3+ years related experience Commercial HMO, PPO products knowledge

• 3+ years related experience Medicare and/or Medicaid products knowledge

Preferred Qualifications:

• Intermediate knowledge of Microsoft Office, specifically Excel and PowerPoint

• Location preference - Kansas, Missouri or surrounding area

• A ready business acumen and the ability to balance and articulate competing priorities while making decisions

• Strong and persuasive communication skills, especially written communications, with external stakeholders

• Strong critical thinking, problem resolution and interpersonal skills

• Adept at execution and delivery (planning, delivering, and supporting) skills

• Adept at collaboration and teamwork

• A growth mindset (agility and developing yourself and others) skills

Education

• Bachelor’s Degree or equivalent professional experience