Provider Contracting Representative

Expanding Brentwood, TN based Medicare health plan is seeking a Provider Contracting Representative to build our health plan's provider network within the assigned region. Specific duties will include:
Explaining health plan benefit plans to attract providers
Provide, explain and negotiate contracts with all types of providers including physicians, hospitals, physician groups/IPA's and ancillary providers
Perform basic financial analysis of potential contracts and payment arrangements to determine profitability
REQUIREMENTS
Bachelor’s degree and three years experience in managed care network development/provider contracting
Must be fluent in all current provider payment methodologies including per diems, DRG's, APC's, ASC's
Must have very strong negotiation, organizational and presentation skills
Must be able to effectively communicate with all levels of facility, office management, and staff to explain contract terms and health plan benefit packages
Must have reliable transportation, as significant local travel and some regional travel will be required
Prior experience with Medicare Advantage is very helpful but not required.
Individuals should be highly motivated and able to work independently but with a team focus
Excellent computer skills, including MS Office Suite



Windsor Management Services, Inc. is an Equal Opportunity Employer