CarePlus Health Plans
Provider Contracting & Network Management
CarePlus Health Plans, Florida, New York, United States
Provider Contracting & Network Management
Director of Hospital Contracting at CarePlus Health Plans
Company Description
CarePlus Health Plans is dedicated to serving Medicare beneficiaries across Florida with kindness, respect, and care. Supporting this mission is a team of committed associates, agents, brokers, and plan providers. With a focus on fostering healthier and happier communities, CarePlus prioritizes the well‑being of its members. At CarePlus, we believe in making a difference each day through our compassionate approach to healthcare.
Role Description
This is a full‑time remote role for a Provider Contracting Network Representative based in FL. The role involves managing provider relationships, negotiating contracts, and ensuring compliance with healthcare regulations. Responsibilities include monitoring and maintaining provider network adequacy, addressing provider inquiries, and evaluating network performance to ensure quality and efficiency. Collaborative engagement with internal teams to support organizational goals is also a key aspect of the role.
Qualifications
Experience in provider relations, contract negotiation, and network development
Knowledge of healthcare regulations and Medicare policies
Strong communication, relationship management, and problem‑solving skills
Ability to analyze data and metrics to evaluate provider network performance
Proficiency in relevant software and tools for documentation and reporting
Bachelor's degree in Healthcare Administration, Business, or a related field is preferred
Experience with managed care organizations or health insurance plans is a plus
Seniority level
Entry level
Employment type
Full‑time
Industries
Insurance
Location: Remote (Florida)
#J-18808-Ljbffr
CarePlus Health Plans is dedicated to serving Medicare beneficiaries across Florida with kindness, respect, and care. Supporting this mission is a team of committed associates, agents, brokers, and plan providers. With a focus on fostering healthier and happier communities, CarePlus prioritizes the well‑being of its members. At CarePlus, we believe in making a difference each day through our compassionate approach to healthcare.
Role Description
This is a full‑time remote role for a Provider Contracting Network Representative based in FL. The role involves managing provider relationships, negotiating contracts, and ensuring compliance with healthcare regulations. Responsibilities include monitoring and maintaining provider network adequacy, addressing provider inquiries, and evaluating network performance to ensure quality and efficiency. Collaborative engagement with internal teams to support organizational goals is also a key aspect of the role.
Qualifications
Experience in provider relations, contract negotiation, and network development
Knowledge of healthcare regulations and Medicare policies
Strong communication, relationship management, and problem‑solving skills
Ability to analyze data and metrics to evaluate provider network performance
Proficiency in relevant software and tools for documentation and reporting
Bachelor's degree in Healthcare Administration, Business, or a related field is preferred
Experience with managed care organizations or health insurance plans is a plus
Seniority level
Entry level
Employment type
Full‑time
Industries
Insurance
Location: Remote (Florida)
#J-18808-Ljbffr