DescriptionProvider Network Contractor III develops and maintains provider networks yielding a competitive, geographic, stable network that achieves objectives for unit cost performance and trend management. Produces an affordable and predictable network for customers and business partners. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.
Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties. This is a senior level professional position that is accountable for more complex responsibilities with minimal supervision. Also serves as a resource to others.
Qualifications:
- Complete working knowledge and skill with ability to be fully proficient in professional field
- Bachelor's degree or equivalent experience in related field
- 5+ years of applicable work experience beyond degree; ex. provider contracting, provider negotiations, network management, etc.
- Familiarity with contract methodologies such as fee-for-service and value-based required
- Experience with understanding quality and provider performance metrics required
- Oklahoma provider network experience strongly preferred
This position requires COVID-19 vaccination per Medica's Employee COVID-19 Vaccination Policy. If you are hired, you would be expected to be fully vaccinated for COVID-19 prior to starting the position, unless a medical or religious exemption is needed. Medica is an Equal Opportunity Employer and provides reasonable accommodations in compliance with the ADA and Title VII.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Equal Opportunity Employer including Veterans and Disabled Individuals