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Sr. Contract Negotiator (Managed Care) Work from home at MultiPlan

Sr. Contract Negotiator (Managed Care) Work from home

MultiPlan Lake Forest, CA Full-Time
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JOB DESCRIPTION

PLEASE NOTE: This is a work-from-home position that will cover the southwest region including Arizona, Colorado and Nevada.

Network Development professionals -- are you looking for a rewarding new position with an industry leader with a firm commitment to its employees? Join our team at MultiPlan! Founded in 1980, we are the industry's most comprehensive provider of healthcare cost management solutions. We have over 1,000,000 healthcare providers under contract, an estimated 68 million consumers accessing our network products, and 40 million claims reduced through our network and non-network solutions each year.

JOB RESPONSIBILITIES

As a Sr. Contract Negotiator, you will be responsible for identifying and evaluating opportunities, negotiating optimal reimbursement rates, and drafting contracts for an assigned provider network to ensure patient access to the highest quality, cost-effective providers of healthcare services in accordance with applicable regulations and MultiPlan's policies, practices and procedures. In addition, this position is responsible for working with management in the aggressive execution of regional strategies based on market trends and client expectations as well as continuing evaluation of the region's network in terms of penetration and discounts.

Your specific duties in this role will include:

  1. Assist management in the identification and development of contracting priorities for assigned territory to support Network Development contracting initiatives.
  2. Negotiate and execute 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.
  3. Foster and maintain superior provider relationships. Respond to provider questions, issues, and problems that have been appropriately escalated and produce a solution.
  4. May manage relationships with leased networks.
  5. Maintain, and preferably exceed, contracting production and quality standards consistent with established regional goals.
  6. Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends.
  7. Serve as mentor to less experienced Provider Contractors through on-going instruction, coaching, modeling, and counseling aimed at developing the type of skills and behaviors that will result in successful resolution of provider contracting. Share provider contracting insights and information with less experienced contractors.
  8. Work with Regional Sales and Account Management 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.
  9. Partner with HCE to conduct financial analyses and monitoring of marker trends to identify, develop, and implement competitive reimbursement.
  10. Provide support in facilitating education and training opportunities for contract team members. Comply with mandatory training programs requirements, including Human Resources, product orientation and contracting tools and resources.
  11. 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).
  12. Collaborate, coordinate, and communicate across disciplines and departments.
  13. Demonstrate Company's Core Competencies and values held within.
  14. 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.
 

Recommended skills

Human Resources
Regional Sales
Account Management
Training
Market Trend
Quality Management
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Job ID: 7798-2

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