Curative
Senior Network Contracting Specialist
Curative
Responsibilities
Manages contract negotiations with large physician groups and ancillary providers; conducting several negotiations simultaneously to meet growth demands
Deep understanding and experience with all clinical specialties to ensure contract terms and conditions address the coding structures most impacted by negotiations
Proactively builds relationships that nurture provider partnerships to support the local market strategy
Initiates, nurtures, and maintains effective communication channels with matrix partners including Claims, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales, and Marketing
Responsible for meeting unit cost targets while preserving an adequate network to achieve and maintain a competitive position
Identify and manage initiatives to improve total medical cost and quality, including renegotiation of existing agreements
Prepare, analyze, review, and project the financial impact of high‑spend or increasingly complex provider contracts and alternate contract terms
Collaborate cross‑functionally to manage provider compensation and pricing development activities, submission of contractual information, and review analysis of reports as part of negotiation and reimbursement‑modeling activities
Assist in resolving elevated provider service complaints; research and negotiate with internal/external partners/customers to resolve complex and/or escalated issues
Manage key provider relationships and serve as a critical interface with providers and business staff
Coach and support new team members on negotiation strategies and successful approaches
Demonstrate comprehensive knowledge of providers in an assigned geographic area by understanding interrelationships and the competitive landscape
Partner with Regulatory Affairs to ensure all network filings are timely and accurate; participate with Compliance to ensure adherence to established guidelines supporting Mental Health Parity
Position Requirements
Bachelor’s degree or equivalent experience in a related field, including 7+ years of experience with Texas hospitals and providers beyond the degree within provider contracting and/or health insurance
Existing relationships with major health systems and large physician groups in Texas are required
Superior problem‑solving, decision‑making, negotiating skills, contract language and financial acumen
Experience with physician group and ancillary provider contracting and negotiations
Experience negotiating delegated credentialing agreements
Experience developing and managing key provider relationships, including senior executives
Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners
Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models
Team player with proven ability to develop strong working relationships within a fast‑paced organization
Ability to influence both sales and provider audiences through strong written and verbal communication skills; experience with formal presentations
Customer‑centric and interpersonal skills are required
Seniority Level Mid‑Senior level
Employment Type Contract
Job Function Legal
Industry Hospitals and Health Care
We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or veteran status.
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Responsibilities
Manages contract negotiations with large physician groups and ancillary providers; conducting several negotiations simultaneously to meet growth demands
Deep understanding and experience with all clinical specialties to ensure contract terms and conditions address the coding structures most impacted by negotiations
Proactively builds relationships that nurture provider partnerships to support the local market strategy
Initiates, nurtures, and maintains effective communication channels with matrix partners including Claims, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales, and Marketing
Responsible for meeting unit cost targets while preserving an adequate network to achieve and maintain a competitive position
Identify and manage initiatives to improve total medical cost and quality, including renegotiation of existing agreements
Prepare, analyze, review, and project the financial impact of high‑spend or increasingly complex provider contracts and alternate contract terms
Collaborate cross‑functionally to manage provider compensation and pricing development activities, submission of contractual information, and review analysis of reports as part of negotiation and reimbursement‑modeling activities
Assist in resolving elevated provider service complaints; research and negotiate with internal/external partners/customers to resolve complex and/or escalated issues
Manage key provider relationships and serve as a critical interface with providers and business staff
Coach and support new team members on negotiation strategies and successful approaches
Demonstrate comprehensive knowledge of providers in an assigned geographic area by understanding interrelationships and the competitive landscape
Partner with Regulatory Affairs to ensure all network filings are timely and accurate; participate with Compliance to ensure adherence to established guidelines supporting Mental Health Parity
Position Requirements
Bachelor’s degree or equivalent experience in a related field, including 7+ years of experience with Texas hospitals and providers beyond the degree within provider contracting and/or health insurance
Existing relationships with major health systems and large physician groups in Texas are required
Superior problem‑solving, decision‑making, negotiating skills, contract language and financial acumen
Experience with physician group and ancillary provider contracting and negotiations
Experience negotiating delegated credentialing agreements
Experience developing and managing key provider relationships, including senior executives
Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners
Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models
Team player with proven ability to develop strong working relationships within a fast‑paced organization
Ability to influence both sales and provider audiences through strong written and verbal communication skills; experience with formal presentations
Customer‑centric and interpersonal skills are required
Seniority Level Mid‑Senior level
Employment Type Contract
Job Function Legal
Industry Hospitals and Health Care
We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or veteran status.
#J-18808-Ljbffr