Provider Contracting Manager

Zing Health•Remote, IL

8d•$84,000 - $94,000

About The Position

Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. The Sr. Network Manager will manage provider contracting and network development for all lines of business. The Sr. Network Manager is responsible for developing, executing, and maintaining a provider network strategy. Continuously evaluates network to ensure cost effective, optimal functionality. Works in concert with Sales & Marketing and Health Services in developing actions to meet market growth and medical cost targets.

Requirements

Medicare Experience Preferred
3 - 5 years of experience in a Managed Care environment, Network Management or Provider Services
Hospital contracting experience or related Network Management position with the ability to perform the level of duties of the position
Demonstrated negotiation, analytic, and problem-solving skills
Experience or knowledge of provider reimbursement methods and claims processing systems
Verbal and written communications skills to include interpersonal and presentation skills
Ability to work effectively and independently. Demonstrated ability to effectively manage multiple priorities

Responsibilities

Contracts and negotiates with Hospital, FQHCs, Physicians and Ancillary providers for all product lines
Conducts Provider Orientations and ongoing education to Network Providers
Understands and explains fee-for-service and risk contracts
Manages physician network by developing and maintaining relationships to drive business results within a specific geographic area
Responds to provider’s contract requests and inquiries
Analyzes network gaps and identifies providers to contract
Reviews and amends provider’s contracts when necessary
Evaluates contracted network to ensure functionality
Research and develop relationships with non-contracted providers
Collects credentialing and required documents for newly contracted providers
Performs special projects as assigned