Physical Health PN Contract Manager (Remote)
About the position Responsibilities • Establish and maintain strong business relationships with Health Systems and ensure appropriate distribution of provider specialties. • Negotiate and re-negotiate provider organization contract terms, payment structures, and reimbursement rates. • Analyze financial impact of contracts and terms. • Maintain contracts and documentation within a tracking system. • Advise executives on functional strategies regarding significant matters. • Act as the single point-of-contact for ongoing contractual and service issues for providers. • Facilitate provider education and training to enhance familiarity with Vaya's systems. • Create and review trend analyses and summaries for decision-making purposes. • Interface with Vaya network and department leaders to align provider development needs and projects. • Design innovative programs to enhance access to care for various populations. • Work with provider organizations and community stakeholders to implement new programs and improve member access to care. • Apply network configuration and incentive-based payment models to improve quality and efficiency. • Assist in resolving complex business problems affecting major functions or disciplines. Requirements • Bachelor's degree in Public Administration, Business, or Human Services required; Master's degree preferred. • 2-5 years of relevant network management experience including contracting with Healthcare Providers and network administration in a healthcare company. • Proficiency in analyzing and communicating financial trends. • Strong customer service skills and excellent verbal and written communication skills. • Ability to manage multiple priorities in a fast-paced environment. • High level of proficiency in Microsoft Office applications. • Demonstrated success in provider relations with large provider groups and/or ancillary providers. • Expert level knowledge of CMS reimbursement methodologies. Nice-to-haves • Extensive provider contracting skills, including contract preparation and implementation, financial analysis, and rate proposal development. • Experience with Medicaid and Value Based Contracting utilizing financial modeling in making rate decisions. • Bilingual in Spanish or Chinese. Benefits • Remote work opportunity • Flexible working hours within 8:30am-5:00pm EST Apply tot his job