Employers Health Network LLC
  • Orlando, FL, USA
  • Full Time

Medical, Dental, Vision, Life, Disability, 401(k)


Senior Provider Contracting Professional

Are you interested in joining a rapidly-growing, dynamic medical network company working in a full-plate plus environment?  EMPLOYERS HEALTH NETWORK is growing and looking for incredible talent!  Employers Health Network provides comprehensive healthcare plans, which allow employers to provide exceptional quality healthcare benefits at the lowest possible cost. Our plans connect employees directly with the best quality healthcare providers and our fully transparent pricing allows customers to see, understand and control their healthcare benefit spending.

Currently, we are experiencing accelerated growth in a rapidly changing industry. There's never been a better time to join our team. We are seeking motivated, coachable, self-driven individuals that possess a servant leadership philosophy and are looking for long term positions at Employers Health Network.

 

Role and Responsibilities

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements EHN provider networks. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Work assignments may also involve moderately complex to complex issues and negotiations where the analysis of situations and/or data requires an in-depth evaluation of variable factors. The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms.  The main responsibilities included but are not limited to:

  • Maintains contracts and documentation within a tracking system.
  • Assist with identifying and recruiting providers based on network composition and needs.
  • Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
  • Makes decisions on moderately complex to complex issues regarding technical approach for project components.
  • Participates in decisions on moderately complex to complex issues regarding technical approach for project components.
  • Adheres to Company Work Flow Processes

Required Skills and Competencies

  • Strong proficiency with MS Excel, Data Bases, Word and other analytic tools
  • Strong customer service skills
  • Excellent verbal and written communications skills
  • Understanding of healthcare analytics
  • Experience in negotiating simple to complex managed care/commercial contracts
  • Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
  • Excellent written and verbal communication skills 

Position Type and Expected Hours of Work

This is a full-time, salaried position. Days and hours of work are typically Monday through Friday, 8:00 a.m. to 5:00 p.m., with occasional after-hours or weekend duties.  

Travel

Travel could be up to 50% of time periodically. 

Qualifications and Education Requirements

  • Bachelor's degree in Health Administration, Business Administration related field or equivalent experience
  • 3-5 years of progressive network management experience including hospital contracting and/or network administration in a healthcare company
  • Intermediate level of proficiency in claims processing and issue resolution
  • Proficiency with MS Word, Excel, PowerPoint and Access
  • Valid driver's license and ability to travel up to 50% of the time periodically
Employers Health Network LLC
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