Description: Our client is currently seeking a Provider Network Contracting
This role will be responsible for developing the provider network for a Medicare Advantage and Medicaid Managed Care network through contract negotiations and relationship development.
- This role will support network contracting for a health plan expanding their provider network in the market for Medicaid Managed care and Medicare Advantage.
- Client will lead the day to day contracting to support this expansion effort with provider contracting and network expansion and is seeking resources with expertise building networks.
- Client will follow the Health Plan’s process for provider recruitment and contracting to targeted populations for the Medicaid and Medicare Advantage plans.
- Client will follow the Health plans protocols for provider network development and contracting.
- Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
- Must works independently and requires high level of judgment and discretion.
Day to day work includes
- Lead telephonic, electronic and in-person provider recruitment contracting to targeted providers for participation in the network
- Track and maintain documentation of provider outreach with goal to collect the signed agreement from providers within target timelines utilizing Plan tracking database.
- Lead provider recruitment efforts to targeted provider for participate in the Plan’s network.
- Drive initial and follow up recruitment to obtain signed network Provider Amendments and Agreements for participation in the targeted programs.
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