Presbyterian Healthcare Services
Network Contract Manager II
Presbyterian Healthcare Services, Albuquerque, New Mexico, United States, 87101
OverviewNow hiring Network Contract Manager II
This position is responsible for drafting, reviewing, negotiating and finalizing contracts in a highly competitive environment, which includes but is not limited to physicians, allied professionals, and behavioral health agreements that are fiscally and operationally responsible in a designated geographic area based on sound analytical principles and approaches.
How you belong matters here.
We value our employees' differences and find strength in the diversity of our team and community.
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us:
Full Time - Exempt: Yes
Job is based Cooper Center
Work hours: Days
Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
Qualifications
High school diploma plus three to five years experience in healthcare. Bachelors degree preferred. Three to Five years of experience in provider relations, provider contracting, or customer service in a healthcare organization. Superior oral, written, interpersonal skills required to interface with internal and external customers.
Three to five years experience in provider relations and customer service in a managed care organization or equal experience.
Must demonstrate strong analytical skills and detail-oriented skills with regards to data analysis reports.
Must demonstrate strong verbal and written communications skills with strong interpersonal and negotiations skills.
Must also have a strong working knowledge of Microsoft Office products and other personal computing skills.
Accuracy and attention to detail are crucial.
SKILL-Ability to effectively interact with customers to understand their needs and explain data
SKILL-Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies.
Functioning as an Effective Team Member
Responsibilities
Use various department input and feedback, network adequacy reports, including competitive network analysis, etc., to identify network gaps in existing assigned networks and recruit providers so networks remain competitive and compliant with state and federal regulations.
Collaborate with team and create strategies for meeting network growth.
This position prepares, analyzes, reviews and projects financial impact of provider contracts prior to and/or during external negotiation.
Specific responsibilities include but are not limited to: strategic positioning for network development, monitoring financial performances, and ensuring compliance with contracting guidelines.
This position involves a high degree of personal interaction with the management team, as well as providers and other health plan staff.
Position requires ability to facilitate and present complex ideas at inter-department meetings to ensure proper interpretation and configuration of contracts.
Demonstrates a knowledge and understanding of providers to present and make recommendations regarding network needs, looking always to expand the network to support profitable market growth.
Responsible for interpreting and explaining issues related to contracting and provider payment methodology.
Coordinate with Configuration and Testing Department the prioritizing of contracting requests. Work closely with Contracting Audit with PHP Audit Department and ensure proper configuration of those scheduled contracts.
Travel as required to meet with providers for purposes of recruitment and contracting related meetings.
BenefitsAll benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift card and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to
USD $36.48/Hr.Compensation Disclaimer
The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
This position is responsible for drafting, reviewing, negotiating and finalizing contracts in a highly competitive environment, which includes but is not limited to physicians, allied professionals, and behavioral health agreements that are fiscally and operationally responsible in a designated geographic area based on sound analytical principles and approaches.
How you belong matters here.
We value our employees' differences and find strength in the diversity of our team and community.
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us:
Full Time - Exempt: Yes
Job is based Cooper Center
Work hours: Days
Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
Qualifications
High school diploma plus three to five years experience in healthcare. Bachelors degree preferred. Three to Five years of experience in provider relations, provider contracting, or customer service in a healthcare organization. Superior oral, written, interpersonal skills required to interface with internal and external customers.
Three to five years experience in provider relations and customer service in a managed care organization or equal experience.
Must demonstrate strong analytical skills and detail-oriented skills with regards to data analysis reports.
Must demonstrate strong verbal and written communications skills with strong interpersonal and negotiations skills.
Must also have a strong working knowledge of Microsoft Office products and other personal computing skills.
Accuracy and attention to detail are crucial.
SKILL-Ability to effectively interact with customers to understand their needs and explain data
SKILL-Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies.
Functioning as an Effective Team Member
Responsibilities
Use various department input and feedback, network adequacy reports, including competitive network analysis, etc., to identify network gaps in existing assigned networks and recruit providers so networks remain competitive and compliant with state and federal regulations.
Collaborate with team and create strategies for meeting network growth.
This position prepares, analyzes, reviews and projects financial impact of provider contracts prior to and/or during external negotiation.
Specific responsibilities include but are not limited to: strategic positioning for network development, monitoring financial performances, and ensuring compliance with contracting guidelines.
This position involves a high degree of personal interaction with the management team, as well as providers and other health plan staff.
Position requires ability to facilitate and present complex ideas at inter-department meetings to ensure proper interpretation and configuration of contracts.
Demonstrates a knowledge and understanding of providers to present and make recommendations regarding network needs, looking always to expand the network to support profitable market growth.
Responsible for interpreting and explaining issues related to contracting and provider payment methodology.
Coordinate with Configuration and Testing Department the prioritizing of contracting requests. Work closely with Contracting Audit with PHP Audit Department and ensure proper configuration of those scheduled contracts.
Travel as required to meet with providers for purposes of recruitment and contracting related meetings.
BenefitsAll benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift card and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to
USD $36.48/Hr.Compensation Disclaimer
The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.