PROVIDER CONTRACTOR - NOT REMOTE
Company: Prime Health Services
Location: Fairview
Posted on: September 29, 2024
Job Description:
Description:***NOT A REMOTE POSITION***General Summary of
Provider Contractor Duties The Provider Contractor role is
responsible for identifying, recruiting, and negotiating contracts
with individual physicians, provider groups, ancillary facilities,
and other medical provider groups to join the Prime Health Services
PPO network. The contracting process includes negotiations focused
on workers' compensation, commercial group health, auto liability,
and personal injury. Provider Contactor Essential Job Functions
- Recruits Providers via phone, email, or mail campaigns to
negotiate PPO contracts for PHS Core business initiatives; ensuring
contracts are cost effective and in compliance with all State,
Federal, and corporate requirements,
- Recruits and manages Specialty Network builds and Special
Projects as assigned for PHS Clients via Client Nominations
- Negotiates payment rates and payment terms for new and existing
contracts within PHS corporate requirements including terms and
conditions associated with State or Federal guidelines
- Performs data analytics of proposed rates to ensure contracts
for new and existing Providers align with defined contracting
guidelines
- Meets/exceeds daily call metrics, completion of negotiated
contracts as defined by contracting leadership, which is subject to
review and modification
- Manages and oversees assigned contracting tasks for specified
geographic regions
- Ensures contract proposals are complete and accurate prior to
sending information to the Provider for review and/or
signature
- Submits contractual language reviews to Director of Contracting
for review and approval
- Ensures contracts for execution are complete, accurate, and all
applicable documentation is present prior to submission to Director
of Provider Contracting
- Establishes and maintains productive professional relationships
with the provider community
- Resolves escalated contract specific issues of Providers and
Clients
- Enters progress reports and notations regarding contracting
efforts into PHS proprietary database
- Travel may be required as needed to conduct stewardship
meetings with Providers Requirements:Education Required for
Provider Contractors
- Bachelor's Degree in Communications/Business or related field
of study from an accredited college or university, or equivalent
experience required
- Specialist level requires 2 + years of (direct/indirect)
experience and/or proven contracting performance
- Managed care contracting experience and/or healthcare
experience preferredProvider Contractor Competencies
- Excellent communication (written and oral), problem solving,
and time management skills,
- Experience working in a collaborative, team spirited, and
deadline driven environment,
- Must be flexible, adaptable, creative, and self-motivated
(initiative),
- Demonstrate strong customer service and public relations
skills,
- Demonstrated technical skills proficiency, including Microsoft
Office Suite,Benefits
- Medical Insurance (high deductible plan with an HSA)
- Dental Insurance
- Vision Insurance
- Short-term and long-term disability paid by the company
- Group term life paid by the company
- PTO - 160 hours (4 weeks) with the ability to roll over 40
hours and cash out 40 hours at the end of the year
- Fitbit program with monetary rewards
- Employee recognition programs with monetary rewards
- Corporate office amenities - specialty coffee machines,
assorted tea options, smoothie bar, collaborative workspaces, fruit
provide by company and an onsite market
- Regular employee events such as potlucks, video game
tournaments, door decorating contests, Mental Health Awareness
Month activities, and a company carnival just to name a few of our
past eventsAbout UsPrime Health Services (PHS) is a national
medical cost containment company with a noteworthy PPO Network used
by insurance carriers, TPA's, self-insureds, and governmental
entities. Our tech-focused nature allows clients to take advantage
of the flexibility of customization while not compromising on bill
processing speed. Since 2001, we have specialized in medical
provider network development and offer clients a tailored approach
to medical cost containment: quality health care at discounted
rates.PI2074899e8393-26289-35511112
Keywords: Prime Health Services, Franklin , PROVIDER CONTRACTOR - NOT REMOTE, Other , Fairview, Tennessee
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