Senior Manager, Network Contracting & Services - Southeast Region

6+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management. 4+ years of experience managing complex Provider Network strategies and negotiating complex contracts. 3+ years of leadership experience. 3+ years experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry. Bachelor's degree or equivalent professional working experience (preferred). Provider management experience with healthcare systems/hospitals at managed care company (bonus points).

Conduct comprehensive reviews and analyses of provider contracts. Oversee a team of provider network managers, specialists, and associates. Lead high-importance claims dispute and/or settlement negotiations. Manage and negotiate complex contracts with healthcare providers, including Value Based Care agreements. Utilize working knowledge of provider financial issues and competitor strategies. Drive implementation of contracting policies and workflows. Monitor and analyze key metrics for network performance, cost, and provider satisfaction. Provide timely resolution of provider issues related to contract terms, reimbursement, and network participation. Build and maintain positive relationships with healthcare providers. Ensure compliance with all applicable laws and regulations.