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Contract Negotiator

Role overview

Qualifications

  • Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, or related field
  • 2+ years of contracting, provider relations or related experience preferably in healthcare or managed care
  • Valid driver's license

Responsibilities

  • Coordinate and negotiate hospital, physician, and ancillary service agreements
  • Identify and initiate contact with potential providers
  • Negotiate contracts and lead assigned negotiations
  • Evaluate and monitor providers’ performance standards and financial performance of contracts

Key facts

Other skills

  • Communication
  • Teamwork
  • Problem Solving

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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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.
 

Position Purpose: Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi specialty groups) and ancillary service agreements that are in accordance with corporate, health plan and State guidelines.

  • Recruit and develop provider network plan for region and set of providers
  • Identify and initiate contact with potential providers
  • Negotiate contracts
  • Leads assigned negotiations (i.e., hospital, physician and ancillary) and ensure that negotiations result in the unit cost targets expected and meet the objectives of the company and approximate the State’s reimbursement to the provider
  • Facilitate and provide oversight to the provider set-up and contract configuration to ensure accurate claims adjudication
  • Evaluate and monitor providers’ performance standards and financial performance of contracts.
  • Assist with and track credentialing activities
  • Facilitate the organization of provider focus groups
  • Coordinate with internal departments and contracted providers to implement and maintain contract compliance
  • May require up to 10% travel
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field, or equivalent experience. 2+ years of contracting, provider relations or other related experience preferably in a healthcare, managed care, or insurance related environment.

License/Certification: Valid driver's license.

Mississippi is the ideal location for this position, but we will consider candidates working remotely anywhere in the United States. They will be required to work Central Time business hours. Potential for up to 10% Travel in Mississippi.

Pay Range: $56,200.00 - $101,000.00 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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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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