Senior Provider Contract Specialist
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About The Position
The position involves building, optimizing, and enhancing insurance networks through relationship development with key local network participants. The individual will act as a liaison between specific Facility, Ancillary, Delegated, and/or Professional providers and EmblemHealth. Responsibilities include developing provider contracting efforts, overseeing processes, conducting strategic diligence, outreach, and negotiating contracts. The role also entails managing day-to-day operations related to contracts, optimizing contracts, implementing new programs, and assisting with provider issues and education materials. The individual will be the contact for escalated issues from providers and internal EmblemHealth departments, including grievances, disputes, and billing complaints.
