Manage Provider Contracting/Provider Relations and Payor Contracting/Payor Relations for IPN. Ensure that contracts with Providers and Payors are supportive of IPN operations, protect the integrity of IPN, and can be administered effectively. Direct development of the provider network, including provider recruitment and establishment of relationships with contract personnel at hospitals, physician groups, and other key providers. Ensure IPN participation in provider forums or other avenues available to promote participation with IPN and support IPN’s vision as a significant resource to providers. Maintain excellent client relationships with payors and employers and work to develop new relationships with potential clients.
Develop and recommend provider reimbursement and changes in fee schedules. Work with the Executive Director on new initiatives, programs, and strategic planning.
Supervise and provide guidance to assigned staff. Maintain communication and coordination with other IPN departments to ensure business continuity and effectiveness, providing a cohesive quality service for IPN customers.
Work Experience: Minimum of five years of experience within healthcare either working for a provider (physician’s clinic/office, facility, etc.), third party administrator (TPA) or health insurance carrier. Equivalent combination of education and experience may apply. Two to four years of management experience preferred.
Education, Certificates, Licenses: High school graduate required with Bachelor’s degree preferred. Prefer Certified Professional Coder certification (CPC®.)
Knowledge: Effective written and verbal communication skills. Exceptional grammar, spelling, punctuation, consistency, proofreading, and editing skills. Excellent interpersonal skills including negotiating and oral presentation skills. Basic math skills required, including percentages, ratios, graphing and spreadsheet skills. Strong analytical and problem solving skills, ability to critically review and interpret complex materials. Ability to work under time pressures and varying workloads. Requires ability to define and prioritize problems and manage workload without direct supervision.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.