Contract Negotiator

Company: Sunshine State Health Plan
Location: Pompano Beach
Posted on: March 14, 2023

Job Description:

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi specialty groups) and ancillary service agreements that are in accordance with corporate, health plan and State guidelines.

--- Recruit and develop provider network plan for region and set of providers
--- Identify and initiate contact with potential providers
--- Negotiate contracts
--- Leads assigned negotiations (i.e., hospital, physician and ancillary) and ensure that negotiations result in the unit cost targets expected and meet the objectives of the company and approximate the State's reimbursement to the provider
--- Facilitate and provide oversight to the provider set-up and contract configuration to ensure accurate claims adjudication
--- Evaluate and monitor providers' performance standards and financial performance of contracts.
--- Assist with and track credentialing activities
--- Facilitate the organization of provider focus groups
--- Coordinate with internal departments and contracted providers to implement and maintain contract compliance
--- May require up to 25% travel

Education/Experience: Bachelor's degree in Healthcare Administration, Business Administration, Marketing, related field, or equivalent experience. 2+ years of contracting, provider relations or other related experience preferably in a healthcare, managed care, or insurance related environment.

License/Certification: Valid driver's license.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Sunshine State Health Plan, Pompano Beach , Contract Negotiator, Other , Pompano Beach, Florida