Provider Contractor Executive - Hybrid

Company: Prime Health Services
Location: Franklin
Posted on: April 1, 2025

Job Description:

Description:***NOT A REMOTE POSITION***Hybrid: 4 days in office, 1 day from homeGeneral Summary for a Provider Contractor ExecutiveThe Provider Contractor Executive is responsible for identifying, recruiting, negotiating and contracting providers to join the Prime Health Services PPO network with a focus on workers' compensation, commercial group health, auto liability, and personal injury Provider Contractor Executive Essential Job FunctionsRecruitment of Providers, ancillary facilities, hospitals and health systems via phone, email, or mail campaigns to negotiate PPO contracts for PHS Core business initiatives; ensuring contracts are cost effective and in compliance with all State, Federal, and corporate requirementsNegotiates payment rates and payment terms for new and existing contracts within PHS corporate requirements including terms and conditions associated with State or Federal guidelinesSuccessfully negotiates PPO contracts with large medical provider groups, independent hospitals, integrated care models, and health care systemsAnalyzes data to develop strategies for contracting and re-contractingPerforms data analytics of proposed rates to ensure contracts for new and existing providers align with defined contracting guidelinesMeets/exceeds daily call metrics, completion of negotiated contracts as defined by contracting leadership, which is subject to review and modificationManages and oversees assigned contracting tasks for specified geographic regionsEnsures contract proposals are complete and accurate prior to sending information to the Provider for review and/or signatureEstablishes and maintains productive professional relationships with the Provider, hospitals, and health systemsEnters progress reports and any notations regarding contracting efforts into PHS proprietary database Travel up to fifty percent (50%) may be required as needed to conduct stewardship meetings with Providers Requirements:Bachelor's Degree in Communications/Business or related field of study from an accredited college or university, or equivalent experience requiredSenior Level - 5+ years and Executive Level - 8+ years of managed care contract experience preferredDemonstrated negotiation skills and experience interfacing with C-Suite level contactsCompetencies of a Provider Contractor ExecutiveMust be able to successfully work in a remote, collaborative, deadline driven work environmentProfessional, friendly demeanor with excellent written and oral communication skillsFlexible, adaptable, creative, organized, and self-motivatedMust have strong negotiations and problem-solving skills and the ability to prioritizeStrong customer service, public relations, and technical skills required, including Microsoft Office BenefitsMedical Insurance (high deductible plan with an HSA)Dental Insurance Vision Insurance Short-term and long-term disability paid by the companyGroup term life paid by the companyPTO - 160 hours (4 weeks) with the ability to roll over 40 hours and cash out 40 hours at the end of the yearFitbit program with monetary rewardsEmployee recognition programs with monetary rewardsCorporate office amenities - specialty coffee machines, assorted tea options, smoothie bar, collaborative workspaces, fruit provide by company and an onsite marketRegular employee events such as potlucks, video game tournaments, door decorating contests, Mental Health Awareness Month activities, and a company carnival just to name a few of our past eventsAbout UsPrime Health Services (PHS) is a national medical cost containment company with a noteworthy PPO Network used by insurance carriers, TPA's, self-insureds, and governmental entities. Our tech-focused nature allows clients to take advantage of the flexibility of customization while not compromising on bill processing speed. Since 2001, we have specialized in medical provider network development and offer clients a tailored approach to medical cost containment: quality health care at discounted rates.PIa63baaa814e4-25660-37276372

Keywords: Prime Health Services, Franklin , Provider Contractor Executive - Hybrid, Other , Franklin, Tennessee