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Provider Contracting Negotiator

* Responsible for management of hospital and physician contracts, including contract negotiations and ongoing management of contracting issues.

* Leads negotiations with network providers, including responsibility for the end to end management of provider negotiations and ongoing contract management.

* In conjunction with leadership, develops negotiation strategies based on assessment of baseline analytics, financial targets, contractual terms, IBC strategic objectives and industry trends.

* Ensures provider contracting is consistent with claim payment methodologies.

* Accountable for ongoing management of an assigned contract portfolio including assessment and resolution of issues, contract performance monitoring unit-cost budgeting, ongoing provider engagement and incentive plan performance.

* Ensures that non-standard contract elements are communicated to appropriate departments and obtains AMFC and Plan approval prior to submission to provider.

* Ensures that contract requirements are communicated timely and accurately to operational areas throughout term of each contract. 

* Works closely with network services team to ensure servicing issues are being resolved in accordance with contractual terms.

* Coordinates with internal stakeholders (e.g.

Care Management, Legal, Operations) to ensure contract terms are administered correctly and issues are incorporated into negotiation objectives.

* Communicates negotiation status to Director and senior leadership throughout process.

* Assists in the development of FHN strategies, reimbursement methodologies and processes.

* Builds and maintains positive relationships with counterparts in the Provider community.

* Performs other duties as assigned.


* Bachelor’s degree in business or health related discipline such as Healthcare Administration or Healthcare Management .

Master’s Degree preferred.

* Minimum of 5 years hospital contracting/reimbursement experience in healthcare setting.

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