1199SEIU Benefit and Pension Funds
Manager, Physician Network Contracting (Hybrid)
1199SEIU Benefit and Pension Funds - New York, New York, us, 10261
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Manager, Physician Network Contracting (Hybrid)
role at
1199SEIU Benefit and Pension Funds Join to apply for the
Manager, Physician Network Contracting (Hybrid)
role at
1199SEIU Benefit and Pension Funds Manage the activities of physician contracting which include preparing and maintaining contracts and complex contracting and negotiations for fee for service, and value-based reimbursements with providers (e.g., large physician groups) Draft single case Letter of Agreements and Long-term Letter of Agreements with providers and physician groups Develop reimbursement models and negotiate renewal agreements with large physician groups and independent provider associations (IPAs) Ensure timely response to provider inquiries related to contract terms and payment methodologies via email, telephone, written correspondence, and on-site/virtual meetings Reinforce contract terms with Physicians, internal Fund departments, escalate time sensitive issues and ensure timely communication on network updates and changes Facilitate review of escalated claims and evaluates contract terms and work with internal departments to obtain issue resolution within the prescribed timeframe Act as liaison between internal departments and ensure all contract language issues, problematic administrative terms and recommendations are tracked and issued annually prior to the contract re-negotiation period Manage projects including but not limited to Request for Information/Proposal, benefit changes, and other programs and initiatives as required Perform additional duties and projects as assigned by management
Requisition #:
6963
# of openings:
1
Employment Type
Full time
Position Status
Permanent
Category
Non-Bargaining
Workplace Arrangement
Hybrid
Fund
1199SEIU National Benefit Fund
Job Classification
Exempt
Responsibilities
Manage the activities of physician contracting which include preparing and maintaining contracts and complex contracting and negotiations for fee for service, and value-based reimbursements with providers (e.g., large physician groups) Draft single case Letter of Agreements and Long-term Letter of Agreements with providers and physician groups Develop reimbursement models and negotiate renewal agreements with large physician groups and independent provider associations (IPAs) Ensure timely response to provider inquiries related to contract terms and payment methodologies via email, telephone, written correspondence, and on-site/virtual meetings Reinforce contract terms with Physicians, internal Fund departments, escalate time sensitive issues and ensure timely communication on network updates and changes Facilitate review of escalated claims and evaluates contract terms and work with internal departments to obtain issue resolution within the prescribed timeframe Act as liaison between internal departments and ensure all contract language issues, problematic administrative terms and recommendations are tracked and issued annually prior to the contract re-negotiation period Manage projects including but not limited to Request for Information/Proposal, benefit changes, and other programs and initiatives as required Perform additional duties and projects as assigned by management
Qualifications
Bachelors degree in Business or Health Care Administration required; Masters degree preferred Minimum five (5) years of experience working in a healthcare management setting required; to include two (2) years supervisory experience required Proficient in Microsoft Word and Excel Excellent verbal, interpersonal and written skills Strong negotiation and influential skills and solid problem-solving skills Ability to travel throughout the New York metropolitan area Knowledge of provider contracting methodology including understanding of Accountable Care Organization (ACO) Model, Quality-Based Shared Savings Program (QSSP) and payor roles, responsibilities, and challenges Knowledge and thorough understanding of government regulations and requirements as they relate to physician contracting Ability to work in a fast-paced environment and foster positive working relationships, multi-task and meet deadlines
The first six months of this position will be 100% in the office for newly hired employees.
Seniority level
Seniority level
Mid-Senior level Employment type
Employment type
Full-time Job function
Job function
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Manager, Physician Network Contracting (Hybrid)
role at
1199SEIU Benefit and Pension Funds Join to apply for the
Manager, Physician Network Contracting (Hybrid)
role at
1199SEIU Benefit and Pension Funds Manage the activities of physician contracting which include preparing and maintaining contracts and complex contracting and negotiations for fee for service, and value-based reimbursements with providers (e.g., large physician groups) Draft single case Letter of Agreements and Long-term Letter of Agreements with providers and physician groups Develop reimbursement models and negotiate renewal agreements with large physician groups and independent provider associations (IPAs) Ensure timely response to provider inquiries related to contract terms and payment methodologies via email, telephone, written correspondence, and on-site/virtual meetings Reinforce contract terms with Physicians, internal Fund departments, escalate time sensitive issues and ensure timely communication on network updates and changes Facilitate review of escalated claims and evaluates contract terms and work with internal departments to obtain issue resolution within the prescribed timeframe Act as liaison between internal departments and ensure all contract language issues, problematic administrative terms and recommendations are tracked and issued annually prior to the contract re-negotiation period Manage projects including but not limited to Request for Information/Proposal, benefit changes, and other programs and initiatives as required Perform additional duties and projects as assigned by management
Requisition #:
6963
# of openings:
1
Employment Type
Full time
Position Status
Permanent
Category
Non-Bargaining
Workplace Arrangement
Hybrid
Fund
1199SEIU National Benefit Fund
Job Classification
Exempt
Responsibilities
Manage the activities of physician contracting which include preparing and maintaining contracts and complex contracting and negotiations for fee for service, and value-based reimbursements with providers (e.g., large physician groups) Draft single case Letter of Agreements and Long-term Letter of Agreements with providers and physician groups Develop reimbursement models and negotiate renewal agreements with large physician groups and independent provider associations (IPAs) Ensure timely response to provider inquiries related to contract terms and payment methodologies via email, telephone, written correspondence, and on-site/virtual meetings Reinforce contract terms with Physicians, internal Fund departments, escalate time sensitive issues and ensure timely communication on network updates and changes Facilitate review of escalated claims and evaluates contract terms and work with internal departments to obtain issue resolution within the prescribed timeframe Act as liaison between internal departments and ensure all contract language issues, problematic administrative terms and recommendations are tracked and issued annually prior to the contract re-negotiation period Manage projects including but not limited to Request for Information/Proposal, benefit changes, and other programs and initiatives as required Perform additional duties and projects as assigned by management
Qualifications
Bachelors degree in Business or Health Care Administration required; Masters degree preferred Minimum five (5) years of experience working in a healthcare management setting required; to include two (2) years supervisory experience required Proficient in Microsoft Word and Excel Excellent verbal, interpersonal and written skills Strong negotiation and influential skills and solid problem-solving skills Ability to travel throughout the New York metropolitan area Knowledge of provider contracting methodology including understanding of Accountable Care Organization (ACO) Model, Quality-Based Shared Savings Program (QSSP) and payor roles, responsibilities, and challenges Knowledge and thorough understanding of government regulations and requirements as they relate to physician contracting Ability to work in a fast-paced environment and foster positive working relationships, multi-task and meet deadlines
The first six months of this position will be 100% in the office for newly hired employees.
Seniority level
Seniority level
Mid-Senior level Employment type
Employment type
Full-time Job function
Job function
Health Care Provider Industries
Hospitals and Health Care Referrals increase your chances of interviewing at 1199SEIU Benefit and Pension Funds by 2x Get notified about new Medical Doctor jobs in
New York, NY . Hospitalist Advisor to Healthcare Venture Capital Firm
New York, NY $200,000.00-$300,000.00 13 hours ago Permanent: OB Hospitalist Position in Brooklyn, NY | 12 or 24-Hr Shifts
RWJBarnabas Health is Seeking an OBGYN Vice Chair in Northern, NJ
Newark, NJ $260,000.00-$485,000.00 6 months ago RWJBarnabas Health is Seeking Full-Time Physician Advisors Throughout New Jersey!
Public Health & Community Internship in Bali
Part-Time Ophthalmology Retina Specialist Physician - NYC Health + Hospitals - Elmhurst Hospital Center
Bronxville, NY $190,000.00-$240,000.00 2 months ago Retina Specialist PT/FT Private Practice Brooklyn, NY- $25K Sign-On Bonus!
Physician Advisor for Healthcare Venture Capital Fund
Board-Certified Neurology Specialist for IME- New York
RWJBarnabas Health is Seeking an Infectious Disease Physician in Jersey City, NJ
Jersey City, NJ $230,000.00-$400,000.00 6 months ago Bronx, NY $215,000.00-$240,000.00 1 month ago Full-Time Hospitalist Physician NYC Health + Hospitals - Elmhurst Hospital Center
New York, NY $229,000.00-$292,000.00 2 weeks ago NYU Langone Hospital Brooklyn Academic Hospitalist
Brooklyn, NY $270,000.00-$350,000.00 3 days ago F/T, P/T and Per-Diem OBGYN Obstetrical Hospitalist Physician - Manhattan, NY
Intensive Care Physician Advisor at Healthcare Venture Capital Fund - Healthcare Shares
Elizabeth, NJ $80,000.00-$95,000.00 2 days ago Newark, NJ $215,000.00-$350,000.00 3 weeks ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr