What are the responsibilities and job description for the Contract Negotiator position at Sunshine State Health Plan?
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose : Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi specialty groups) and ancillary service agreements that are in accordance with corporate, health plan and State guidelines.
- Recruit and develop provider network plan for region and set of providers
- Identify and initiate contact with potential providers
- Negotiate contracts
- Leads assigned negotiations (i.e., hospital, physician and ancillary) and ensure that negotiations result in the unit cost targets expected and meet the objectives of the company and approximate the State’s reimbursement to the provider
- Facilitate and provide oversight to the provider set-up and contract configuration to ensure accurate claims adjudication
- Evaluate and monitor providers’ performance standards and financial performance of contracts.
- Assist with and track credentialing activities
- Facilitate the organization of provider focus groups
- Coordinate with internal departments and contracted providers to implement and maintain contract compliance
- May require up to 25% travel
Education / Experience : Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field, or equivalent experience. 2 years of contracting, provider relations or other related experience preferably in a healthcare, managed care, or insurance related environment.
License / Certification : Valid driver's license.
Candidates must reside in the Panhandle region of Florida to be considered for this role. The is a remote position, but it will require occasional local travel (10% - 25%) for provider visits in the field.
Pay Range : $55,100.00 - $99,000.00 per year
Centene offers a comprehensive benefits package including : competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Salary : $55,100 - $99,000
