Provider Contracting Manager Needed in Atlanta, GA!
This position is located in Atlanta, GA. If you meet the qualifications below, please APPLY NOW!
Position Overview
This position reports to the Director of Contracting and Provider Relations to support the contracting activities of the department. Contracting activities continue to grow substantially in volume, financial impact, and complexity. Existing contracts must be continually renegotiated and aggressively managed. The Manager of Provider Contracting is expected to negotiate, renegotiate and manage contracts that should result in significant reduction of outside medical expense for the company's Health Plan. Areas of responsibility will include IPA’s, PHOs. Hospitals, home health, dental, and other specialty services. Contractual arrangements will be complex and comprehensive, needing a depth of understanding of managed care, negotiation experience, and political sensitivity.
Required Skills/Experience
Major responsibilities
1) Successfully negotiate contracts for cost reduction with specialty service providers. This includes facilities, individuals, networks, using a diverse range of techniques and contracting “best practices”, to include capitation, case rates, and various fee for services arrangements.
2) Participate in the development of Region-wide contracting
3) Prepare RFP’s for the selection of the specialty providers and manage the selection process.
4) Establish, in collaboration with Director, standards for evaluating specialty contract effectiveness, to include development of performance standards. Work with financial analysts to produce reports.
5) Lead Regional department managers, physicians, and medical center personnel in collaborative projects concerning use of specialty services. Network development, cost reduction, development of processes and communication tool, contract implementation, and problem resolution.
a. Consistently supports compliance and the Principles of Responsibility (company Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and the company's policies and procedures.
b. Your access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform your jobc. May perform other duties as assigned Core CompetenciesFunctional Competenciesa. Decision Makingb. Communication
c. Developing Othersd. Directing Worke. Motivating Othersf. Team Focus. Results Orientation
Job Competencies
1. Knowledge of contracting process
2. Basic financial analytical skills
3. Basic computer skills
4. Understanding HMO operations
5. Understanding Atlanta community
Desired Skills/Experience
Minimum Experience Requirements:
1) Business, healthcare administration, public health, or related experience
2) A broad based knowledge of healthcare and the various medical delivery systems, legal issues, business/ finance related experience in healthcare, with the understanding of the many financial reimbursement methodologies used in managed care is required. Excellent organizational and prioritization skills, the skills, the ability to work under tight deadlines, high productivity is required. Knowledge of and practice with, the “art” or negotiation is critical, along with good communication skills, sensitivity to the dynamics of the local healthcare market and key individuals, and common sense are essential.
3) Five years business/ finance related experience in healthcare in required
4) Negotiation, financial management, analytical skills, excellent communications and human interaction skills are necessary.
Education Requirements
Bachelor Degree: Required
Master's Degree: Preferred
Other Certifications
* Experience in a managed care environment preferred
• General knowledge of various health plan processes such as claims payment, quality assurance, utilization management, and data analysis are useful, but not absolutely required.
Please visit us on the web at www.frontlinesourcegroup.com
Equal Opportunity Employer, M/F/V/D. Candidates must have authorization to work in the U.S. Client will not sponsor visas.
Frontline Source Group is one of the fastest growing Information Technology, Accounting, Legal, Human Resource, Administrative and Clerical staffing and direct firms based in Austin Dallas/Fort Worth Houston Texas.
Frontline specializes in matching top talent with companies for direct, contract and contract-to-hire placements. We work with clients and candidates in all areas of North America and Canada.
