Provider Contracting Director jobs in the United States

Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director of Provider Development & Contracting
  • Provider Partners Health Plan
  • Indianapolis, IN FULL_TIME
  •  
    Provider Partners is searching for a results-oriented individual, with a proven track record, who is passionate about our mission and can generate positive outcomes based on that mission. The Director of Provider Development & Contracting plays a pivotal role in managing and developing relationships with healthcare providers within our network. This position is responsible for ensuring a high level of provider satisfaction and service while optimizing network performance and strategy.
     
    Key Responsibilities: 
     
    Provider Relationship Management:
    • Serve as the primary contact for healthcare providers.
    • Maintain and enhance strong, long-term relationships with providers.
    • Address and resolve provider inquiries and concerns in a timely and professional manner.
    • Conduct provider orientations and provide ongoing education on PPHP policies, procedures, and new initiatives.
    Network Development and Management:
    • Identify, recruit, and contract with new providers to expand our network.
    • Negotiate contract terms, rates, and agreements with providers.
    • Analyze network performance, identify gaps, and recommend improvements.
    • Work collaboratively with internal teams to ensure network adequacy and to develop network strategies.
    Performance Monitoring and Reporting:
    • Monitor provider performance metrics and ensure compliance with contractual and regulatory requirements.
    • Prepare and present network performance reports to senior management.
    • Evaluate provider satisfaction and recommend strategies for improvement.
    Compliance and Regulatory Adherence:
    • Ensure provider compliance with state, federal, and PPHP regulations and standards.
    • Stay abreast of changing regulatory requirements and ensure timely communication to providers and internal stakeholders.
    Project Management:
    • Lead and participate in cross-functional projects aimed at improving network performance and provider satisfaction.

    Qualifications:
    • Bachelor’s degree in healthcare administration, business, or related field required; Master’s degree preferred.
    • Minimum of 5-10 years of experience in healthcare network management or provider relations in the state of Indiana.
    • Strong knowledge of healthcare industry, contract negotiations, and regulatory compliance.
    • Excellent communication and interpersonal skills with the ability to build strong relationships with providers and internal teams.
    • Strong analytical and problem-solving skills.
    • Ability to manage multiple priorities in a fast-paced environment.
    • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).

  • 1 Month Ago

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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 ...
  • 1 Day Ago

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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 ...
  • 14 Days Ago

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Director - Provider Network Development & Contracting
  • Wellmark Blue Cross and Blue Shield
  • Des Moines, IA FULL_TIME
  • Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not...
  • 2 Days Ago

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Contracting Officer
  • US Office of the Director of National Intelligence
  • Bethesda, MD FULL_TIME
  • Duties Oversee the identification, analysis, and participation in the development of acquisition strategies based on requirements (e.g., technical, management, cost, past performance) and establish in...
  • 27 Days Ago

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Contracting Officer Technical Representative
  • US Office of the Director of National Intelligence
  • Vienna, VA FULL_TIME
  • Duties Plan, prepare, justification, administration, analysis, forecasting, and monitoring of contractual agreements to ensure delivery of Intelligence Community (IC) programs; oversee budget/financia...
  • 19 Days Ago

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Well-Being Emotional Support Provider
  • Ohio Health
  • Columbus, OH
  • We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong p...
  • 5/29/2024 12:00:00 AM

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Field Installation Technician **Company Vehicle Provided**
  • Fairborn Equipment Midwest
  • Columbus, OH
  • Job Description Job Description We are seeking a Dock & Door Install Technician to join our team! You will install loadi...
  • 5/29/2024 12:00:00 AM

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Remote Licensed Professional Counselors Mental Health Service Provider (LPCMHSP) - Tennessee
  • Headway
  • Columbus, OH
  • Are you a Licensed Professional Counselors Mental Health Service Provider (LPCMHSP) in Tennessee in South Dakota looking...
  • 5/28/2024 12:00:00 AM

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Insurance Inspector - Personal and Commercial Lines
  • Information Providers Inc.
  • Columbus, OH
  • Job Description Job Description Come work with us! Information Providers, Inc is a field service company that conducts u...
  • 5/28/2024 12:00:00 AM

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Coord Provider Network - Remote, Ohio Region
  • AmeriHealth Caritas
  • Dublin, OH
  • **Coord Provider Network - Remote, Ohio Region** Location: Dublin, OH Primary Job Function: Medical Management ID**: 341...
  • 5/27/2024 12:00:00 AM

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Project Coordinator
  • Tech Providers Inc
  • Westerville, OH
  • Role: Project Coordinator Location: Westerville, OH Duration: 2+ Months Contract (Possible Extension) Job Description: W...
  • 5/27/2024 12:00:00 AM

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Orient, OH - Medical - ODRC - Correctional Reception Center (CRC) - Behavioral Healthcare Provider 2 - Region 5 - Mental
  • Correctional Reception Center
  • Orient, OH
  • Weekly Pay Range - $1348 To $1497 Position Summary: A SOCIAL WORKER help people with a broad range of issues, including ...
  • 5/26/2024 12:00:00 AM

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Systems/Network Engineer for local IT Managed Services Provider
  • EasyIT
  • Dublin, OH
  • Job Description Job Description Interested in an exceptional technical growth opportunity? How about advancement/promoti...
  • 5/25/2024 12:00:00 AM

Income Estimation for Provider Contracting Director jobs
$172,912 to $249,740