Provider Contract Manager Job in Bothell 98011, Washington US
PROVIDER CONTRACT MANAGER
POSITION SUMMARY
Negotiate agreements with integrated delivery systems, hospitals and groups that result in high quality, cost effective and marketable providers.
PRINCIPLE ACCOUNTABILITIES
- Negotiate large group, ancillary and facility contracts.
- Responsible to maintain positive provider relationships with assigned clients.
- Advise appropriate internal stakeholders on contract negotiations,
- Evaluate provider network and implement strategic plans with the goal of meeting Molina’s network adequacy standards outlined in the QI Work Plan.
- Assess contract language for compliance and review revised language with attorney.
- Participate in fee schedule determinations including development of new reimbursement models.
- Develops and implements contracting strategies to meet Molina’s financial objectives.
- Participate on the management team and other committees addressing the strategic goals of the department and organization.
· Other duties and responsibilities as assigned.
Additional Knowledge, Skills and Abilities include (but not limited to):
- Strong communication and teaming/interpersonal skills; strong leadership capabilities, and ability to initiate and maintain cross-team relationships.
- Strong presentation skills (verbal and written).
- Strong analytical and reasoning abilities.
- Managed care culture and philosophy. Excellent communication skills, verbal and written. Ability to interact well with both internal and external customers required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education:
· Requires a Bachelor’s degree in a healthcare related field or an equivalent combination of education and experience.
Experience:
· 5 years minimum experience in Managed Care (including Medicaid/Healthy Options and other State governed plans).
· 3 years experience in contract negotiations.