Professional, Provider Relations - Contracting

MVP Health Care•Schenectady, NY

8d•Hybrid

About The Position

Join Us in Shaping the Future of Health Care At MVP Health Care, we’re on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference—every interaction, every day. We’ve been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team. What’s in it for you: Growth opportunities to uplevel your career A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team Competitive compensation and comprehensive benefits focused on well-being An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace. You’ll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities. This position works with Network leadership, Provider Partnership team members and other key leaders/contributors across the organization to develop, recruit, negotiate, implement, oversee, and evaluate professional/ancillary contracts for the region. Ensures network adequacy and performance for MVP members.

Requirements

Bachelors Degree preferred, equivalent experience may be substituted if the candidate can demonstrate significant relevant work experience.
Minimum of 5 years in health insurance or equivalent experience in Finance or Contract Management or equivalent provider office experience.
Knowledge of ICD-10, CPT-4, HCPCS coding
Strong proficiency in problem solving and analysis
Demonstrated ability to interact with all levels of management
Adaptability and flexibility in a changing environment
Ability to use Excel, Microsoft Office, Power Point
Excellent presentation skills
Excellent follow up skills
Excellent verbal and written communication skills
Hybrid work schedule – in office and work from home
Onsite provider meetings (travel required)

Responsibilities

Professional/Ancillary recruitment related but not limited to county expansions, access and availability requirements and member need/demand.
Professional/Ancillary contracting execution including: Coordinates with Analytics Team to generate performance reporting and associated financial models.
Assists Leaders in leveraging of competitive transparency data during contract negotiation and annual performance reviews.
Assists with developing contract documents for renewals and/or amendments in compliance with company templates, reimbursement structure standards and other key process controls.
Supports the business relationships with Providers as it relates to contracting issues.
Ensures the smooth operation and administration of provider agreements.
Advancement of Value Based Payment Models, such Primary Care Model Maintains an inventory of contracts, renewal dates, term clauses/end dates, spend and services by LOB.
Processes forms, tracks and scans signed/executed agreements and amendments.
Assists with Provider Payment Policies as necessary.
Participates in meetings and supports successful implementation for assigned projects.
Ability to maintain confidentiality and adhere to regulatory compliance issues as they exist and change from time to time.
Proactive in identifying areas for efficiency improvement across all of Network Management; consistently challenges the status quo in favor of incremental improvement opportunities that could be achieved through new methods.
Performs other related duties as assigned.