Provider Contractor Executive

Prime Health Services, Inc.•Franklin, TN

4h•Onsite

About The Position

The Provider Contractor Executive is responsible for identifying, recruiting, negotiating and contracting providers to join the Prime Health Services PPO network with a focus on workers’ compensation, commercial group health, auto liability, and personal injury with a focus on hospitals and health systems.

Requirements

Bachelor’s Degree in Communications/Business or related field of study from an accredited college or university, or equivalent experience required
8+ years of managed care contract experience preferred
Demonstrated negotiation skills and experience interfacing with C-Suite level contacts
Must be able to successfully work in a collaborative, deadline driven work environment
Professional, friendly demeanor with excellent written and oral communication skills
Flexible, adaptable, creative, organized, and self-motivated
Must have strong negotiations and problem-solving skills and the ability to prioritize
Strong customer service, public relations, and technical skills required, including Microsoft Office

Responsibilities

Recruitment of Providers, ancillary facilities, hospitals and health systems via phone, email, or mail campaigns to negotiate PPO contracts for PHS Core business initiatives; ensuring contracts are cost effective and in compliance with all State, Federal, and corporate requirements
Negotiate payment rates and payment terms for new and existing contracts within PHS corporate requirements including terms and conditions associated with State or Federal guidelines
Successfully negotiates PPO contracts with large medical provider groups, independent hospitals, integrated care models, and health care systems
Analyzes data to develop strategies for contracting and re-contracting
Performs data analytics of proposed rates to ensure contracts for new and existing providers align with defined contracting guidelines
Meets/exceeds daily call metrics, completion of negotiated contracts as defined by contracting leadership, which is subject to review and modification
Manages and oversees assigned contracting tasks for specified geographic regions
Ensures contract proposals are complete and accurate prior to sending information to the Provider for review and/or signature
Establishes and maintains productive professional relationships with the Provider, hospitals, and health systems
Enters progress reports and any notations regarding contracting efforts into PHS proprietary database
Travel up to fifty percent (50%) may be required as needed to conduct stewardship meetings with Providers