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Manager Network Contracting

Company: CHRISTUS Health
Location: Irving
Posted on: January 13, 2022

Job Description:

Description
Summary: The Manager of Network Contracting is responsible for collaborating across organization in the execution of the network strategy for all US Family Health Plan and CHRISTUS Health Plan product lines. Leads negotiations and guides contractors throughout the contract negotiation process.
Ensures that the networks and supporting contracts are in compliance with standards, reimbursement, legal, financial, quality, controls, etc.
Ensures health plan compliance with regulatory network requirements by monitoring network adequacy and identifying recruitment opportunities.
Ensures providers are accurately and timely loaded into provider databases.
Oversees the development of reimbursement models in concert with senior leadership. Communicates new strategies for consideration.
Oversees the development of provider contracting strategies, identifying those specialties and geographic locations where network expansion is necessary.
Oversees the maintenance of all Provider Contract Templates. Works with legal and Network Director on an as needed basis to modify contract templates and ensures compliance with all contractual and/or regulatory requirements.
Utilizes standardized contract templates and Pay for Performance strategies.
Responsible in maintaining strong business relationship with the hospital systems and large provider groups. Requirements: Education: Bachelor's Degree Business Administration, Healthcare Administration or a related field and exemplary experience required. Master's Degree in Business Administration, Healthcare Administration or a related field strongly preferred.
Strong presentation, analytical and negotiation skills.
Effective oral and written communication skills.
Seven (7) or more years of significant experience in provider network contracting. Ten (10) or more years preferred.
Knowledgeable and compliant with all relevant laws, rules regulations, accreditation standards and requirement. Work Type: Full Time

Keywords: CHRISTUS Health, Irving , Manager Network Contracting, Executive , Irving, Texas

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