About the position
Responsibilities
• Establish and maintain strong business relationships with Health Systems and ensure appropriate distribution of provider specialties.
• Negotiate and re-negotiate provider organization contract terms, payment structures, and reimbursement rates.
• Analyze financial impact of contracts and terms.
• Maintain contracts and documentation within a tracking system.
• Advise executives on functional strategies regarding significant matters.
• Act as the single point-of-contact for ongoing contractual and service issues for providers.
• Facilitate provider education and training to enhance familiarity with Vaya's systems.
• Create and review trend analyses and summaries for decision-making purposes.
• Interface with Vaya network and department leaders to align provider development needs and projects.
• Design innovative programs to enhance access to care for various populations.
• Work with provider organizations and community stakeholders to implement new programs and improve member access to care.
• Apply network configuration and incentive-based payment models to improve quality and efficiency.
• Assist in resolving complex business problems affecting major functions or disciplines.
Requirements
• Bachelor's degree in Public Administration, Business, or Human Services required; Master's degree preferred.
• 2-5 years of relevant network management experience including contracting with Healthcare Providers and network administration in a healthcare company.
• Proficiency in analyzing and communicating financial trends.
• Strong customer service skills and excellent verbal and written communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• High level of proficiency in Microsoft Office applications.
• Demonstrated success in provider relations with large provider groups and/or ancillary providers.
• Expert level knowledge of CMS reimbursement methodologies.
Nice-to-haves
• Extensive provider contracting skills, including contract preparation and implementation, financial analysis, and rate proposal development.
• Experience with Medicaid and Value Based Contracting utilizing financial modeling in making rate decisions.
• Bilingual in Spanish or Chinese.
Benefits
• Remote work opportunity
• Flexible working hours within 8:30am-5:00pm EST
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