Senior Provider Engagement and Contracting Representative- Central Florida

MaxHealth is looking to hire a Senior Provider Engagement and Contracting Representative for the Central Florida area. This position is responsible for the development and growth of positive long-term relationships with our contracted PCPs non-PCP providers, and health plans to support and improve the financial and quality performances of our MaxHealth clinics.

This person will be responsible for provider contracting, day-to-day front line relationship management, training, education, population health, data sharing/connectivity, responding to provider inquiries, and other areas as they relate to provider performance, patient experience, market growth, provider experience and operational excellence.

This position is based out of the Tampa area with some hybrid/work from home flexibility. Travel will be needed as necessary throughout Florida.

Salary- Based on experience and qualifications.

Job Qualifications:

• 4 years of experience in managed care working directly with providers in a value-based care environment.
• 4 years of experience improving and managing provider performance to include but not limited to population health metrics (documentation coding, STARS, HEDIS), utilization KPIs, MLR drivers, growth, and practice operations/workflows.
• 4 years of network management experience including value based contracting and contract administration.
• 4 years of provider contracting skills, including contract preparation and implementation of financial analysis, and rate proposal development.
• 4 years of experience in project leadership and implementation.
• 4 years of experience with a health plan and/or medical practice with a high concentration of Medicare Advantage or Accountable Care Organization eligibles.
• Exceptional relationship management and interpersonal skills

Essential Job Duties/Responsibilities

• Accountable for managing assigned Affiliate and ACO provider relationships, contracts, strategies, performance and is the primary conduit between the provider, health plans and the business dyads.
• Must successfully collaborate and communicate on the status of assigned work with various internal and external stakeholders to include but not limited to, care management, risk adjustment, quality, finance, medical leaders, data/reporting, health plans, PCPs, risk management and other cross functional teams.
• Obtain, create, and analyze financial, quality, utilization and other performance metric reports impacting performance.
• Manage strategic positioning for provider contract, develop networks and identify opportunities for greater customer value, retention, and risk arrangements.
• Connect with providers and operators routinely to include a monthly meeting and at a minimum quarterly joint operations meeting.
• Prepare reports/documents, to assists with engagement, reporting and follow-up activities.
• Oversee and manage provider contracting and maintenance of all in-scope providers.
• Assist in resolving moderately complex to complex business, service, performance, and contractual needs.
• Assist in the development of the department strategies and goals.
• Ensure the accurate implementation, and execution of business objectives.
• Develop and drive the onboarding strategies and/or Practice Improvement Plans (PIPs) to ensure success of new and existing PCP practices and organizational goals.
• Educate and implement strategies on, health plan products, contract requirements, partnerships, processes, provider network, policies and procedures and compensation arrangements.
• Ensure PCPs are maximizing and utilizing the plans contracted network effectively and efficiently to include the use of participating providers, capitated network/vendors and assisting with preferred provider relationships.

This healthcare position earns a competitive wage, depending on experience. We provide fantastic benefits, including health benefits, a 401k plan, life insurance, long-term disability, paid holidays, and PTO (paid time off)! 

If this sounds like the right patient care opportunity for you, apply today!

ABOUT MAXHEALTH

MaxHealth is a rapidly growing medical practice with clinics spread across central and southern Florida. With expanded locations and easy access to MaxHealth care, we offer convenient appointments, including telehealth and urgent care. Our patients choose us because we provide easy access to a complete range of patient-centered services. Achieving our mission of becoming Florida's leading national provider of high-value primary and specialty care services keeps us focused on reinventing the relationship between patients and healthcare providers for the better.

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