Oversee provider contracting, provider relations, provider partnerships, provider network development, and strategic initiative deployment in assigned territory for PacificSource Health Plans. Work with senior leadership in Health Services, Finance, Sales and Government Programs to develop key strategies with maximum positive impact. Deploy resources and oversee key work processes to achieve critical goal attainment across all lines of business including commercial, Medicare and Medicaid. Work collaboratively with senior leadership in Finance, Operations, AUA, Sales, IT, Health Services, Revenue ,Government Programs, and across teams in Provider Network – as well as external contracted vendors, and external provider partners.
Work Experience: 5 years in healthcare and 3 years in provider contracting, provider relations, or provider network operations required.
Education, Certificates, Licenses: Bachelor’s Degree in related field required.
Knowledge: Advanced knowledge of provider reimbursement and reimbursement methodologies, provider relations, or provider partnership activities in relevant markets and geography.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
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.