Provider Contracting Manager jobs in New York
Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Recently Added Provider Contracting Manager jobs
Director of Payer and Provider Contracting
- Great Lakes Integrated Network IPA (GLIN IPA)
-
Buffalo, NY
CONTRACTOR
-
The Director of Payer and Provider Contracting is responsible for developing, strategizing, and negotiating contracts with health plans for all lines of business and related product lines, as well as designing partnership opportunities to grow and develop GLIN’s high-performing, clinically-integrated network of providers.
Duties and Responsibilities (including but not limited to)- Contract Negotiation:
- Lead the negotiation process for payer contracts, including fee-for-service, value-based, and alternative payment models.
- Negotiate provider contracts to ensure alignment with payer agreements and IPA objectives.
- Develop negotiation strategies to optimize reimbursement rates and contract terms.
- Contract Development and Management:
- Develop contractual agreements with payers and providers, ensuring compliance with regulatory requirements and ACO policies.
- Collaborate with legal and compliance teams to review, finalize, and execute contracts.
- Monitor contract performance and compliance, identifying opportunities for improvement or renegotiation.
- Ensure overall compliance for network management processes including oversight and management of the provider network, provider rosters, and payer and provider data elements.
- Relationship Management:
- Cultivate and maintain strong relationships with payer organizations, including health insurance companies, government payers, and other stakeholders.
- Collaborate with internal departments, including finance, analytics, operations, legal, compliance, and clinical teams, to align contracting strategies with organizational goals.
- Serve as the primary point of contact for payer and provider inquiries, escalations, and dispute resolution.
- Market Analysis and Strategy:
- Conduct market analysis to identify payer and provider trends, competitive landscape, and opportunities for partnership.
- Develop strategic initiatives to expand the IPA's network, increase market share, and improve financial performance.
- Monitor industry changes and regulatory developments to inform contracting strategies and risk mitigation.
- Performance Evaluation and Reporting:
- Evaluate contract performance metrics, including reimbursement rates, utilization, and quality outcomes.
- Prepare and present reports on contract performance to executive leadership and relevant stakeholders.
- Recommend adjustments to contracting strategies based on performance analysis and market dynamics.
- Other duties as assigned
- Education: Baccalaureate degree in business, economics, finance, or related field
- Minimum of 5 years’ experience in healthcare contracting/analytics/network management
- Minimum of 2 years’ experience managing people, teams, and processes
- An understanding and application of medical billing and reimbursement procedures/practices
- An understanding of proper negotiation techniques
- Excellent communication skills, including presentation of complex topics, written and oral communication skills
- Strategic mindset, with the ability to develop and execute contracting strategies aligned with organizational objectives
- Ability to work independently in a fast-paced environment
- Ability to interact with management personnel and the provider community
- Possess strong organizational skills and attention to detail
- Ability to multi-task and meet multiple deadlines
- Adaptive and flexible to new ideas and change
- Strong supervisory and leadership skills
- Excellent interpersonal and negotiation skills
- Strong analytical and problem-solving skills
- Ability to adapt to the needs of the organization and employees
- Proven ability to prioritize tasks and to delegate them when appropriate
- Proficient with Microsoft Office Suite or related software
- This is a hybrid-remote position and candidates must reside in WNY to be considered.
Pay range: $110,000. to $160,000.
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within job’s compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and expertise of the individual and internal equity considerations
Equal Employment
Our culture encourages individual development, embraces an inclusive environment, rewards innovative excellence, and leads New York in provider and patient satisfaction. Great Lakes Integrated Network (GLIN) values diversity, inclusion, and equity as matters of fairness and effectiveness. We are committed to hiring and retaining a staff that reflects the diversity of the communities we serve, fostering an inclusive working environment where staff of all backgrounds feel welcomed and engaged.
Great Lakes Integrated Network is an Equal Opportunity Employer - 1 Day Ago
Senior Provider Contracting Professional
- Humana Health Insurance Company of Florida, Inc.
-
Florida, NY
FULL_TIME
- Become a part of our caring community and help us put health first The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts...
- 10 Days Ago
Director of Payer and Provider Contracting
- Great Lakes Integrated Network, Inc.
-
Buffalo, NY
FULL_TIME
- The Director of Payer and Provider Contracting is responsible for developing, strategizing, and negotiating contracts with health plans for all lines of business and related product lines, as well as ...
- 27 Days Ago
Account Manager (Wireless, Based in New York)
- Wireless Provider
-
New York, NY
FULL_TIME
- VHA- Account Manager At VHA, our mission is to be passionately committed to providing value and profitability to our partners and employees through the VHA way. Our award-winning service to the prepai...
- 1 Month Ago
Physician Compensation & Contracting Manager
- Garnet Health
-
Middletown, NY
FULL_TIME
- OverviewAt Garnet Health, the Hudson Valley’s leading integrated health system, you’ll find the perfect balance of a satisfying career and a rewarding lifestyle. Our focus is on patient-centric care w...
- 9 Days Ago
MANAGER CONTRACTING & CORPORATE AFFAIRS
- Montefiore Health System
-
Yonkers, NY
FULL_TIME
- This position negotiates and implements various types of contracts on behalf of the multiple affiliates of the Montefiore Health System. Those contractsinclude managed care (FFS), value based, busines...
- 9 Days Ago
Provider Contracting Manager jobs at Popular Companies
Associate Provider Contract Manager
- Kaiser Permanente
-
Burbank, CA
- Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
- 6/12/2024 12:00:00 AM
Senior Provider Contract Manager
- Kaiser Permanente
-
Oakland, CA
- Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
- 6/12/2024 12:00:00 AM
Senior Manager-Contract Management, Americas
- Idaho State Job Bank
-
Boise, ID
- Senior Manager-Contract Management, Americas at Marriott in Boise, Idaho, United States Job Description Job Number 24034...
- 6/12/2024 12:00:00 AM
Contracts Manager
- Inari Medical, Inc.
-
Irvine, CA
- Description The Contracts Manager, working independently, closely collaborates with the finance, legal, compliance, and ...
- 6/11/2024 12:00:00 AM
Manager - Contract Management and Payer Variance
- ChristianaCare
-
Wilmington, DE
- Are you looking for a career opportunity with growth potential at a healthcare organization that is based on excellence ...
- 6/11/2024 12:00:00 AM
Contracts Manager
- The Trade Desk
-
Irvine, CA
- The Trade Desk is changing the way global brands and their agencies advertise to audiences around the world. How? With a...
- 6/11/2024 12:00:00 AM
Provider Contract Management Specialist
- Naphcare, Inc.
-
Birmingham, AL
- Overview: NaphCare has an excellent opportunity for a Provider Contracting Specialist to join our Regional Office in Pho...
- 6/10/2024 12:00:00 AM
Manager Contract Management
- McDermott
-
Houston, TX
- Job Description Company Overview: People power our future. That is why advancing a dynamic, inclusive environment, where...
- 6/10/2024 12:00:00 AM
About New York
New York is a state in the Northeastern United States. New York was one of the original thirteen colonies that formed the United States.
New York covers 54,555 square miles (141,300 km2) and ranks as the 27th largest state by size.[3] The highest elevation in New York is Mount Marcy in the Adirondacks, at 5,344 feet (1,629 meters) above sea level; while the state's lowest point is at sea level, on the Atlantic Ocean.
In contrast with New York City's urban landscape, the vast majority of the state's geographic area is dominated by meadows, forests, rivers, farms, mountains, and lakes. Most of...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$116,917 to $155,268
Most Popular Cities in New York for Provider Contracting Manager Jobs
What does a Provider Contracting Manager do?
Provider Contracting Manager in Gastonia, NC
By simplifying and automating the provider contracting lifecycle, we help make it easier for health plans to identify and implement savings opportunities to obtain maximum value from provider relationships.
January 09, 2020
Provider Contracting Manager in Springfield, IL
Responsible for the oversight of their assigned networks to ensure network provider deficiencies are being met and working closely with their assigned Network Support staff and Medical Management counterparts to ensure network needs/changes are being effectively addressed and communicated both internally and externally.
January 19, 2020
Provider Contracting Manager in Cedar Rapids, IA
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
February 03, 2020