Job Information

Providence Senior Network Contract Specialist (Remote: SW WA / OR) in Beaverton, Oregon


Providence is calling a Senior Network Contract Specialist who will:

  • Be accountable to lead, develop and maintain strong business/contracting relationships and negotiate contracts with physicians, physician groups, institutions and ancillary providers

  • Be responsible for managing accounts that can be challenging, complex and/or have a material financial impact to the organization

  • Handle larger more complex strategic provider negotiations in collaboration with the contracting department leadership

  • Negotiate contracts, prepare analysis, develop strategies, and research problems

  • Be responsible for identifying and evaluating opportunities, negotiating geographically competitive reimbursement rates, and executing contracts for an assigned provider network (physicians, hospitals, ambulatory surgery centers, other facilities, pharmacies, ancillary providers, etc.) in compliance with company contract templates, reimbursement structure standards, and other key process controls

We welcome 100% remote work for residents of Southwest Washington and Oregon .

Primary Responsibilities:

  • Negotiate provider contracts to support objectives relative to competitive market trends and client expectations

  • Review, negotiate and renegotiate provider contracts including rate and contract language provisions

  • Initiate, foster and maintain strong provider relationships

  • Assists in managing relationships with leased networks

  • Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends

  • Ensure compliance with established policies and procedures, regulatory requirements, and other Health Plan requirements

  • Partner with Financial Analytics and Provider Relations to conduct financial analyses and monitoring of market trends to identify, develop, and implement competitive reimbursement

  • Negotiate single case agreements with non par providers

  • Maintain, and preferably exceed, contracting production consistent with established goals

Additional Responsibilities:

  • Share provider contracting insights and information with less experienced contractors

  • Works closely with Contracting Leadership in the development and implementation of Pay For Performance, Merit Based Pay, and other initiatives

  • Organizes and prioritizes work activity. Displays flexibility in adjusting work priorities

  • Meets routine deadlines/objectives. (e.g. meets legal, contractual, and operational deadlines for renewals. Creates work plans for distributing work load throughout the year)

  • Accept additional responsibilities that contribute to the success of the organization's contracting objectives and are outside of the assigned provider network scope

  • Represent the contracting department on one or more of the organization's committees/teams

  • Manages a capitated services agreement or vendor related agreement, such as behavioral health, physical therapy, vision services or alternative care

Required qualifications for this position include:

  • Bachelor's Degree in Finance, Business Administration, or Healthcare related field -OR- a combination of equivalent education and experience

  • 5 years experience in a network management-related role with accountability for business results

  • 5 years experience working with financial analysis, reporting, and contract negotiations with institutional and professional providers

  • Experience in working with and negotiating arrangements with fee for service or other with physicians, hospitals and other providersdemonstrating a progression of successfully managing more complex negotiations and breadth of provider types

  • Experience working with contracting software and or contract language

Preferred qualifications for this position include:

  • Experience in capitated or risk bearing, medical home, shared savings, global budgets and other performance bonus structure for hospital and physician services

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 124310
Company: Providence Jobs
Job Category: Contracting
Job Function: Legal/Compliance/Risk
Schedule: Full time
Shift: Day
Career Track:
Address: OR Beaverton 3601 SW Murray Blvd

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.