Contract Negotiator III

• Recruit physician, hospital and ancillary service providers to sign network participation agreements in accordance with Corporate, health plan and State guidelines
• Ensure all necessary documentation and information are included
• Recruit and develop a network for a region and set of providers
• Lead assigned physician, hospital and ancillary recruitments
• Ensure complete and accurate standard contracts meet objectives
• Facilitate and oversee provider setup and contract configuration for accurate claims adjudication
• Initiate contact and identify potential providers by geographic and specialty needs
• Update the provider database
• Coordinate with internal departments and contracted providers to implement and maintain contract compliance

Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, related field or equivalent experience
• 4+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician’s office/group setting
• Working knowledge of State and/or Federal health care programs preferred, including Medicaid and Medicare

Core Competencies

Demonstrates expertise in provider recruitment, contract negotiation, and compliance within healthcare settings, ensuring alignment with corporate and state guidelines. Proficient in managing provider databases and facilitating accurate claims adjudication.

Highest-signal resume keywords

• Provider Recruitment
• Contract Negotiation
• Contract Compliance
• Provider Relations
• Healthcare Administration

Hard Skills

• Contract Analysis
• Provider Experience
• Documentation Management
• Claims Adjudication
• Database Management

Soft Skills

• Communication
• Coordination
• Leadership

Industry Keywords

• Healthcare Programs
• Medicaid
• Medicare
• Network Participation Agreements
• Provider Setup