This position serves as an integral member on the Alabama Contracting Team by managing, evaluating, and/or negotiating contracts for medical providers, hospitals, pharmacy and/or ancillary providers in the Alabama market.
Work Location - Birmingham, Huntsville or Mobile, AL (must be located in one of these locations)
Office Based Position - very minimum travel required
Negotiates contracts with providers in Alabama, Mississippi, and North Florida.
Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms.
Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups) for one or more geographies.
Responsible for developing unit-cost management strategies across provider network and accountable for executing those strategies through tactful negotiation with providers.
Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements.
Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
Assists in resolving provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve escalated issues.
Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance
Bachelor Degree or equivalent work experience, required; Master's Degree preferred.
Three to five years of relevant experience, preferred.
Contracting and Negotiating experience, preferred
Experience in developing and managing relationships
Understanding and experience with hospital, managed care, and provider business models a plus
Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
The ability to influence audiences through strong written and verbal communication skills. Experience with formal presentations.
Customer centric and interpersonal skills are required.
Demonstrates an ability to maneuver effectively in a changing environment.
Demonstrates problem solving, decision-making, negotiating skills, contract language and financial acumen.
Knowledge and use of Microsoft Office tools.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
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