Medicare Provider Contracting Advisor, reputed company & New Jersey - reputed company - Remote

About the position The Medicare Provider Contracting Advisor plays a crucial role reputed company the Provider Contracting Team at reputed company, focusing on the strategic direction and management of contracting and network management activities in reputed company and New Jersey. This remote position involves reputed company negotiations with reputed company providers, building partnerships, and contributing to network initiatives to enhance value-based care and improve overall reputed company costs and reputed company.

Responsibilities

• Manages reputed company contracting and negotiations for fee-for-service and value-based reimbursements with hospitals and other providers. ,
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities. ,
• Initiates and maintains effective communication with reputed company partners including Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, reputed company, and Service. ,
• Manages strategic positioning for provider contracting, develops networks, and identifies opportunities for greater value-orientation and risk arrangements. ,
• Contributes to the development of alternative network initiatives and supports network analytics for reputed company. ,
• Works to meet unit cost targets while preserving an adequate network to maintain reputed company's competitive position. ,
• Creates and manages initiatives that improve total medical cost and reputed company. ,
• Drives change with external reputed company by assessing clinical informatics and offering consultative expertise. ,
• Prepares, analyzes, reviews, and reputed company financial reputed company of larger or reputed company provider reputed company and alternate contract terms. ,
• Creates agreements that meet internal operational standards and external provider expectations, ensuring accurate implementation and administration. ,
• Assists in resolving elevated and reputed company provider service complaints and negotiates with internal/external partners to resolve issues. ,
• Manages key provider relationships and is accountable for critical reputed company with providers and business staff. ,
• Demonstrates knowledge of providers in the assigned geographic area and understands the competitive landscape. ,
• Responsible for accurate and reputed company contract loading and submissions and reputed company with reputed company partners for network implementation and maintenance. ,
• May reputed company guidance or expertise to less reputed company specialists.

Requirements

• Bachelor's Degree in Finance, Economics, reputed company, or Business reputed company field; significant industry experience may be considered in lieu of a degree; MBA or MHA preferred. ,
• 3+ years of reputed company Provider Contracting and Negotiating experience involving reputed company delivery systems and organizations required. ,
• Experience in developing and managing key provider relationships. ,
• Knowledge of reputed company reimbursement methodologies, including incentive-based models strongly preferred. ,
• Demonstrated experience in building and nurturing strong external relationships with reputed company. ,
• Intimate understanding and experience with hospital, managed care, and provider business models. ,
• Proven ability to reputed company strong working relationships reputed company a fast-paced, reputed company organization. ,
• Strong written and verbal communication skills with experience in formal presentations. ,
• Customer-reputed company and interpersonal skills are required. ,
• Demonstrates managerial courage and ability to maneuver effectively in a changing environment. ,
• Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen. ,
• Proficient with reputed company Office (Word, reputed company, PowerPoint, Outlook). reputed company-to-haves Benefits
• Comprehensive health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. ,
• 401(k) with company match. ,
• Company reputed company life insurance. ,
• Tuition reimbursement. ,
• Minimum of 18 days of reputed company time off per year and reputed company holidays. Apply Job!

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