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Provider Contracting Specialist in Nashville, TN at Corizon Health

Date Posted: 11/15/2018

Job Snapshot

Job Description

Correctional Care | Committed Careers | Corizon Health

We have an exceptional opportunity for a Senior Provider Contracting Specialist to join our Healthcare Support Team in Brentwood, TN.

Senior Contract Specialist is responsible for negotiating and drafting physician, hospital and ancillary contracts within an assigned region(s). Identifies specialty physicians and ancillary providers needed throughout their regions and vet out when requested by regional staff. Routinely identifies areas of possible cost reductions and renegotiates reimbursement rates. Must be familiar with the RFP process and have the ability to juggle multiple network development projects simultaneously. Responsible for financial analysis utilizing InGauge software. Ability to utilize the QXNT claims system for payment inquiries. Must be able to communicate effectively with other departments and their leadership. Establishes and maintains positive working relationships with regional staff.

Qualifications of the Corizon Health Senior Provider Contracting Specialist

Bachelor's degree preferred

  • Three to five (3-5)years of Managed Care/Healthcare experience
  • One to three (1-3) years' experience in working with Managed Care contract terms and reimbursement methods.
  • Strong interpersonal skills with the ability to coordinate necessary communication at all levels to promote teamwork.
  • QNXT claims system experience a plus.
  • Excellent written and verbal communication skills.
  • Strong Excel and Word knowledge
  • Superior organizational skills and the ability to multi-task high priority projects simultaneously.
  • Detail oriented with strong commitment to follow the project through to completion.
  • Ability to present information in a group setting to internal and external audiences.
  • Ability to travel with overnight stay.

Responsibilities of the Corizon Health Senior Provider Contracting Specialist

  • Contract, negotiate and finalize physician, hospital and ancillary contracts
  • Facilitate issues with the claims department, vendor payroll and accounts payable
  • Perform financial analysis through use of claims systems and managed care reimbursement methodologies
  • Communicates with field personnel to educate on role of Network Development department and policies and procedures.
  • Assist in development of proposal for new business as it relates to the provider network.
  • Implementation of new business for compliance with operational deadlines.
  • Draft and negotiate amendments & addendums to physician, hospital and ancillary contracts
  • Other duties as assigned by the Manager of Network Development.

This position may require a background check, security clearance, and/or drug screening.

Corizon Health is an Equal Opportunity Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status.