Provider Contracting Manager

Provider Contracting Manager
Wheeling, WV Charleston, WV Morgantown, WV Massillon, OH
Full-Time
Provider Delivery Services
Director of Contracting

Duties include negotiation/renegotiation of hospital, provider and ancillary agreements in accordance with The Health Plan, State, and Federal guidelines in order to maintain and enhance the provider network and to meet/exceed The Health Plan's accessibility, quality and financial goals.

Develop and manage relationships and provide support service to assigned hospitals and key provider groups/facilities. 

  1. B.S. Degree or equivalent work experience with a minimum of 5 years experience to include demonstrated, successful provider contract negotiations;
  2. Negotiating direct agreements for all provider types (Hospital, Ancillary and Physician) to meet  Corporate objectives and goals;
  3. Attention to detail and commitment to excellence;
  4. Ability to troubleshoot, problem solve and work as part of a team or independently;
  5. Ability to use programs including Word, Excel and Outlook;
  6. Strong written and oral communication skills;
  7. Experience with hospital, physician and ancillary provider business models;
  8. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position;
  9. Ability to prioritize multiple negotiations with continued follow up to resolution;
  10. Demonstrates high level of integrity, discretion and sound judgement when handling confidential information;
  11. Highly organized and focused.

  1. Knowledge of  provider contract and payment concepts to include value based contracting and alternative payment models;
  2. Demonstrated history of maintaining good relationships with provider groups;
  3. Experience contracting with providers for government programs (Medicare, Medicaid, CHIP, etc.);
  4. Existing WV/Ohio provider relationships.

Employment Documents

EEO

Or, if you are interested in a fast-paced career with us, please send resume with salary requirements to:

HR Department 
1110 Main Street
Wheeling, WV 26003-2704
hr@healthplan.org