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Prime Health Services, Inc. · 4 months ago

Provider Contractor - Specialist

Franklin, TN

Full-time, Contract

Onsite

Entry Level

1+ years exp

Prime Health Services, Inc. is a national medical cost containment company specializing in medical provider network development. They are seeking a Provider Contractor Specialist responsible for recruiting and negotiating contracts with medical providers to join their PPO network, focusing on various healthcare contract negotiations and maintaining professional relationships.

Alternative MedicineHealth CareInsuranceMedical

Responsibilities

Recruits Providers via phone, email, or mail campaigns to negotiate PPO contracts for PHS Core business initiatives; ensuring contracts are cost effective and in compliance with all State, Federal, and corporate requirements

Recruits and manages Specialty Network builds and Special Projects as assigned for PHS Clients via Client Nominations

Negotiates payment rates and payment terms for new and existing contracts within PHS corporate requirements including terms and conditions associated with State or Federal guidelines

Performs data analytics of proposed rates to ensure contracts for new and existing Providers align with defined contracting guidelines

Meets/exceeds daily call metrics, completion of negotiated contracts as defined by contracting leadership, which is subject to review and modification

Manages and oversees assigned contracting tasks for specified geographic regions

Ensures contract proposals are complete and accurate prior to sending information to the Provider for review and/or signature

Submits contractual language reviews to VP of Network Development for review and approval

Ensures contracts for execution are complete, accurate, and all applicable documentation is present prior to submission to VP of Network Development

Establishes and maintains productive professional relationships with the provider community

Resolves escalated contract specific issues of Providers and Clients

Enters progress reports and notations regarding contracting efforts into PHS proprietary database

Travel may be required as needed to conduct stewardship meetings with Providers

Qualification

Managed care contractingHealthcare experienceData analyticsContract negotiationCustomer serviceMicrosoft Office SuiteCommunicationProblem solvingTime management

Required

Bachelor's Degree in Communications/Business or healthcare related field of study from an accredited college or university, or equivalent experience required

1 + year(s) of experience in managed care contracting and/or healthcare is required

Excellent communication (written and oral), problem solving, and time management skills

Experience working in a collaborative, team spirited, and deadline driven environment

Must be flexible, adaptable, creative, and self-motivated (initiative)

Demonstrate strong customer service and public relations skills

Demonstrated technical skills proficiency, including Microsoft Office Suite

Benefits

Medical Insurance (high deductible plan with an HSA)

Dental Insurance

Vision Insurance

Short-term and long-term disability paid by the company

Group term life paid by the company

PTO - 160 hours (4 weeks) with the ability to roll over 40 hours and cash out 40 hours at the end of the year

Fitbit program with monetary rewards

Employee recognition programs with monetary rewards

Corporate office amenities - specialty coffee machines, assorted tea options, smoothie bar, collaborative workspaces, fruit provide by company and an onsite market

Regular employee events such as potlucks, video game tournaments, door decorating contests, Mental Health Awareness Month activities, and a company carnival just to name a few of our past events

Company

Prime Health Services, Inc.

Prime Health Services is a leading national Preferred Provider Organization (PPO) network offering innovative, technology-driven cost containment solutions.

Founded in 1996

Brentwood, Tennessee, USA

201-500 employees