Provider Network Contracting

The Judge Group
November 22, 2020
Wayne, PA
Job Type


Location: REMOTE
Description: Our client is currently seeking a Provider Network Contracting

Job Description:

 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.

Contact: [Click Here to Email Your Resumé]

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