Provider Contract Specialist (Medicare Advantage/Managed Medicaid) - MultiPlan

Provider Contract Specialist – Medicare Advantage and Managed Care

(Network Development Specialist)

Remote

At MultiPlan, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all of our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. 

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and upward!!!  

• Find more information on what it’s like to be a MultiPlan employee on our Careers page at www.multiplan.com

JOB ROLES AND RESPONSIBILITIES

1. Negotiate provider contracts to support penetration and discount objectives relative to competitive market tends and client expectations through comprehensive, aggressive execution of region specific contracting goals derived from national and regional objectives related to penetration and discount objectives, and improved contractual terms.
   
   
2. Foster and maintain superior provider relationships.
   
   
3. Maintain, and preferably exceed, contracting production and quality standards consistent with established regional goals.
   
   
4. Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends.
   
   
5. Partner with HCE to conduct financial analyses and monitoring of market trends to identify, develop, and implement competitive reimbursement.
   
   
6. Work with Regional Sales and Accounts Management Peers to respond to and anticipate access requirements and network related performance guarantees. Use information derived from Requests for Proposals (RFP) to assess network adequacy and competitiveness in region.
   
   
7. Comply with mandatory training programs requirements, including Human Resources, product orientation and contracting tools and resources.
   
   
8. Ensure compliance with established policies and procedures and with regulatory requirements (such as but not limited to HIPAA, integrity, product orientation, and contracting tools/resources).
   
   
9. Collaborate, coordinate, and communicate across disciplines and departments.
   
   
10. Demonstrate Company’s Core Competencies and values held within.
    
    
11. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.