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Contract Negotiator III

Key Facts

Remote From: 
Full time
70 - 126K yearly
English

Other Skills

  • Communication
  • Leadership
  • Time Management
  • Teamwork
  • Detail Oriented
  • Relationship Building
  • Problem Solving

Roles & Responsibilities

  • Bachelor's degree in Healthcare Administration, Business Administration, Finance, related field or equivalent experience
  • 4+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician's office/group setting
  • Working knowledge of State and/or Federal health care programs (Medicaid, Medicare) preferred
  • Experience working with Value Based Provider Groups

Requirements:

  • Recruit physician, hospital and ancillary service providers to sign network participation agreements aligned with corporate, health plan, and state guidelines; ensure documentation is complete
  • Lead recruitment and development of the regional provider network and ensure contracts are complete and accurate
  • Facilitate provider setup and contract configuration to ensure accurate claims adjudication
  • Initiate contact with potential providers by geographic and specialty needs and maintain/update the provider database

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

***Remote role, highly preferred that candidate resides in the state of Texas, the Midwest or the Northeast Tristate area. Seeking a candidate that is experienced in working with Value Based Provider Groups.***

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

Position Purpose: Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State guidelines. Ensure that all necessary documentation and information are included.

  • Recruit and develop network for a region and set of providers
  • Lead assigned recruitments (i.e., physician, hospital and ancillary) and ensure they result in complete and accurate standard contracts that meet objectives
  • Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication
  • Initiate contact and identify potential providers by geographic and specialty needs and update database
  • Coordinate with internal departments and contracted providers to implement and maintain contract compliance

Education/Experience: Bachelor’s degree in Healthcare Administration, Business Administration, Finance, related field or equivalent experience. 4+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician’s office/group setting. Working knowledge of State and/or Federal health care programs preferred (Medicaid, Medicare).

Pay Range: $70,100.00 - $126,200.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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