Employer Industry: Health Insurance

Why consider this job opportunity:
- Salary up to $115,605
- Comprehensive health benefits including Medical, Dental, and Vision
- Generous PTO and paid volunteer time off
- Opportunities for career advancement and growth within the organization
- Incentive plans and wellness programs to support employee well-being
- Tuition reimbursement for continued education and professional development

What to Expect (Job Responsibilities):
- Facilitate and lead network provider negotiations for various medical lines of business including Commercial, Medicare, and Medicaid
- Ensure accurate implementation of contracts and manage provider file maintenance requests
- Collaborate with Medical Economics and Actuary to prepare rate proposals for all lines of business
- Analyze contracts to identify and implement medical cost savings through innovative initiatives
- Develop and implement provider contracting policies and procedures that align with regulatory requirements

What is Required (Qualifications):
- High School Diploma/GED required; Bachelor's degree in business, finance, or health administration preferred
- Minimum of 5 years of business experience in hospital finance and/or managed care network development
- In-depth knowledge of contract finance and reimbursement methodologies including FFS and Medicare DRG
- Minimum of 5 years of provider experience in Commercial, Medicare, Medicaid, and Value-Based Programs
- Proficiency in MS Office products and understanding of health care contracting principles

How to Stand Out (Preferred Qualifications):
- Master's degree in health or business
- Knowledge of laws and regulations regulating insurance and HMO hospital practices
- Proven analytical and product design skills
- Experience in health care cost data analysis and technical document writing
- Strong organizational skills and ability to adapt to multiple responsibilities

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