Providence Senior Network Contract Specialist in Beaverton, Oregon
Providence St. Joseph Health is calling a Senior Network Contract Specialist to our location in Portland, OR.
We are seeking a Senior Network Contract Specialist to be accountable to lead, develop and maintain strong business/contracting relationship and negotiate contracts with physicians, physician groups, institutions and ancillary providers. This role is responsible for managing accounts that can be challenging, complex and/or have a material financial impact to the organization. Larger more complex strategic provider negotiations may be done in collaboration with contracting department leadership. Negotiates contracts, prepares analysis, develops strategies, and researches problems. In addition, this position is 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.
In this position you will have the following 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
Assist in managing relationships with leased networks.
Prepare, analyse report 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.
Required qualifications for this position include:
Bachelor's Degree in Finance, Business Administration, or Healthcare related field -OR- equivalent education/experience.
Five (5) years of experience in a network management-related role with accountability for business results.
Five (5) years of 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 providers, demonstrating a progression of successfully managing more complex negotiations and breadth of provider types.
Experience working with contracting software.
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.
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. 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.
Job Category: Analytics/Business Intelligence
Req ID: 265262