Provider Network Negotiation Specialist

Sedgwick

3d•$70,000 - $75,000

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Provider Network Negotiation Specialist PRIMARY PURPOSE: To negotiate fee-for-service ancillary contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

Requirements

Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred.
Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required.
Strong project management skills
Excellent negotiation skills
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Nice To Haves

Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred.
Two (2) years supervisory experience preferred.

Responsibilities

Negotiates fee-for-service home health and home infusion therapy, and other ancillary services; contracts for multiple lines of business in the managed care markets.
Analyzes market data and financial models.
Prepares, negotiates, and administers provider contracts.
Develops and expands provider participation within the network.
Maintains provider participation within the network.
Monitors provider performance; implements corrective action plans.
Identifies current issues and probable future issues; guides staff through resolution.
Documents contracts; updates contracts as changes occur.
Coordinates customer inquiries.
Performs other duties as assigned.
Supports the organization's quality program(s).