What are the responsibilities and job description for the Network Contracting Specialist position at Curative?
Duties And Responsibilities
- Manages contract negotiations with physicians and physician groups in assigned area.
- Conducting several negotiations simultaneously to meet growth demands.
- Proactively builds relationships that nurture provider partnerships to support the local market strategy.
- Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, 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 competitive position.
- Identify and manage initiatives that improve total medical cost and quality.
- Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
- Assists in resolving elevated provider service complaints. Research problems and negotiate with internal / external partners / customers to resolve complex and / or escalated issues.
- Manages key provider relationships and is accountable for critical interface with providers and business staff.
- Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
- Partner with Regulatory Affairs to ensure all network filings are timely and accurate.
- Performs other duties as assigned
Position Requirements
