What are the responsibilities and job description for the Contract Negotiator position at Sunshine State Health Plan?
Transforming Health, One Person at a Time
At Centene, we are committed to improving the health of our communities. As a key member of our team, you will have the opportunity to make a meaningful impact on the lives of our 28 million members.
Position Purpose:
Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi-specialty groups), and ancillary service agreements that align with corporate, health plan, and state guidelines.
- Develop and lead provider network planning for regions and sets of providers
- Identify and establish relationships with potential providers
- Negotiate contracts
- Lead assigned negotiations (hospitals, physicians, and ancillary services) to achieve unit cost targets and meet company objectives while approximating state reimbursement to providers
- Ensure accurate claims adjudication by facilitating and overseeing provider setup and contract configuration
- Evaluate and monitor providers' performance standards and financial performance of contracts
- Support credentialing activities and facilitate organization of provider focus groups
- Collaborate with internal departments and contracted providers to maintain contract compliance
- May require up to 25% travel
Education/Experience:
Bachelor's degree in Healthcare Administration, Business Administration, Marketing, or related field, or equivalent experience. 2 years of contracting, provider relations, or other related experience preferably in a healthcare, managed care, or insurance environment.
License/Certification:
Valid driver's license.
Candidates must reside in the Panhandle region of Florida to be considered for this role. This is a remote position requiring occasional local travel (10-25%) for provider visits in the field.
Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements. Actual compensation may vary based on an individual's skills, experience, education, and other job-related factors permitted by law.
Centene is an equal opportunity employer committed to diversity and inclusion. We value the unique perspectives and experiences of all qualified applicants and consider them for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.
