Accountable to lead, develop, and maintain strong, positive relationships with assigned standard and complex provider accounts, including assurance of provider satisfaction with PacificSource. Proactively manage assigned provider accounts to achieve PacificSource’s strategies and goals for product and provider contract development.
Work Experience: A minimum of five years of experience in managing provider relationships and provider contract negotiations. Demonstrated ability to develop and execute strategy. Proven negotiation experience. Demonstrated ability to develop and execute strategy.
Education, Certificates, Licenses: BA or BS in business, health care administration, finance, or equivalent combination of education and experience required. Master’s degree preferred.
Knowledge: Excellent public relations and interpersonal skills. Excellent written and verbal communication skills. Strong analytical skills. Ability to draft contract language to meet legal criteria and familiarity with provisions in health insurance. Excellent presentation skills. Understanding of complex financial arrangements and quality programs across health care products. Knowledge of different forms of reimbursement including capitation and their ramifications on providers as well as insurers. Strong data management skills. Demonstrated knowledge of regulatory issues and network development. Strong experience and expertise in the provider environment. Ability to gain a thorough understanding of PacificSource products. Knowledge of provider profiling software, systems, and provider data utilization. Self-starter and the ability to lead with minimal direction. Proven ability to lead and mentor small teams. Strong organizational, planning and administrative skills. Current driver’s license and the ability to travel.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 15% 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.