Accountable to lead, develop, and maintain strong, positive relationships with providers, including assurance of provider satisfaction with IPN. Negotiates agreements and rates which support IPN and PacificSource strategies and goals for product and provider contract development.
Work Experience: Minimum of two years of experience in managing provider relationships and contract negotiations in the healthcare setting: network, physician’s clinic/office, facility, Third Party Administrator or health insurance carrier. Ability to develop and execute strategy. Experience in public speaking and professional communication, both verbal and written is required.
Education, Certificates, Licenses: BA or BS in business, health care administration, finance, or equivalent experience. Current Driver’s License required. Certified Professional Coder certification (CPC®) preferred.
Knowledge: Demonstrated knowledge of various physician and facility reimbursement arrangements. Strong data management skills are essential, along with spreadsheet development, formula writing and a strong command of mathematics and mathematical formulas. Additionally, must have a strong understanding of medical coding (CPT, DRG, HCPC, ICD-10). Knowledge of regulatory issues, national and local healthcare trends and network development is also essential. Demonstrated experience in the provider environment. Knowledge of regulatory issues, Medicare regulations, national and local healthcare trends and network development is also essential. Self-starter with proven ability to lead with minimal direction. Strong organizational, planning and administrative skills. Proficiency with Excel, PowerPoint and SharePoint preferred. Must have the ability to travel.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 25% 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.