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Reporting to the corporate Director of Contract Management, in this position you will be responsible for: the recruitment of new physicians and ancillary providers of health care services; maintaining working relationships with network providers; assessment of provider training needs and the coordination of training programs with Essence staff.
Role and Responsibilities:
This position is accountable and responsible for provider network development and maintenance of network adequacy in the Essence market area:
Recruits and negotiates physician and ancillary service contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals;
Establishes and maintains ongoing relationships with the business leadership of Essence network of physicians and ancillary providers;
Assists in the evaluation of network adequacy by provider type, specialty and/or category; designs and implements contracting strategies to meet Essence network needs and the demands of the provider community;
Monitors provider contract performance to ensure financial, operational and strategic objectives are being satisfied;
Serves as the primary point of contact for provider office staff in answering questions about contract issues and interpretations and, with the assistance of management, resolve any issues that may arise;
Provides in-office training and orientation for new providers regarding Essence products and related polices and operations.
Serve as Subject Matter Expert on provider types as assigned.
Participates in the strategic planning process to address the provider network needs as the Essence market grows.
Experience, Qualifications, and Education:
Bachelor's degree in business, health care administration, or related field preferred;
Significant experience (usually 3 or more years) with a combination of exposure to provider network contracting and/or provider relations;
General knowledge of provider credentialing;
Must be: self-motivated; dependable; team and goal-oriented;
Must have the ability to communicate effectively with diverse groups, all levels of management and staff, internal as well as external to Essence;
Must be patient and able to calmly address and resolve issues in high stress situations;
Must possess strong analytic and problem-solving abilities; excellent time management and organizational skills; and excellent computer skills, including Microsoft Office Suite;
Must have reliable transportation, as significant local travel will be required.
Lumeris is an EEO/AA employer M/F/V/D.
Location:St. Louis, MO
Time Type:Full time