Provider Relations and Contracting Manager (Iowa)

HealthPartners

109d

About The Position

HealthPartners is hiring a Manager of Provider Relations and Contracting. The position is responsible for managing strategic relationships with providers, including provider contracting, financial analysis, operations management, development of strategic partnerships, and coordination with HealthPartners and Contracted Medical Groups. The overall responsibilities include supervising staff, ensuring compliance with organizational policies, establishing positive relationships with providers, developing network contracting strategies, negotiating contract terms, and managing operational needs related to providers.

Requirements

• Bachelor’s degree in health care administration, business administration or other relevant field.
• Minimum of seven years experience working in the health care industry with three years in a provider relations/provider administrative role.
• Previous experience in a management position, independently responsible for planning and development of a key company function.
• Strong analytical and financial modeling skills.
• Ability to develop and evaluate contracting strategies.
• Strong oral and written skills with the ability to make effective group presentations and consensus building.
• Excellent team leadership skills with a sound level of interpersonal effectiveness.
• Ability to work independently, making independent decisions related to successful relationships with providers.

Nice To Haves

• Strong financial and systems background.
• Previous experience in provider contract negotiations.
• Previous experience in health care industry.
• An additional two years experience in network development in specific products, e.g. workers compensation.

Responsibilities

• Supervise staff, including hiring, transferring, laying off, promoting, disciplining, and discharging employees.
• Establish and maintain positive contractual and strategic relationships between HealthPartners and its network of providers.
• Develop and implement network contracting strategies consistent with HealthPartners overall objectives.
• Develop and implement sound reimbursement methodology for providers.
• Negotiate contract terms with providers.
• Work with government programs management to ensure compliance with Medicare product requirements and regulations.
• Create product specific networks as directed by HealthPartners initiatives.
• Coordinate communications between the Health Plan, primary care, specialty, and institutional providers.
• Manage the day-to-day operational needs related to providers.
• Supervise and mentor direct reports, including service specialists and contract consultants.
• Perform project management duties for projects designed to enhance strategic contracted partnerships and services.
• Investigate, mediate, and resolve inquiries regarding the delivery of care by providers.
• Provide support to the Quality Utilization Management Department in analyzing provider trends and developing action plans.

What This Job Offers

• Career Level: Manager
• Education Level: Bachelor's degree
• Number of Employees: 101-250 employees