Job Attributes

Work Schedule/Shift

8AM-5PM

Job ID

5000447723606

Req. No

70034309

Job Title

Network Contractor III

Region

CHRISTUS System Office

Category

Healthcare

Division

Not Defined

Company

CHRISTUS Health

Travel

None

Facility

Corp USFHP-55100

Address

909 Hidden Ridge
Irving, TX  75038
US

Type

Full Time

Apply Now Network Contractor III Job in Irving

Accountable for all aspects of physician and/or provider/facility recruitment and contracting as assigned. Responsible for re-negotiating or negotiating solo, complex group, hospital-based and large entity physician/hospital contracts in support of network quality, availability and financial goals. Negotiate value based deals. Participates in the strategic recruitment of physicians satisfying specific network goals and objectives. Provides network development, maintenance and refinement activities and strategies in support of cross-market network management units. Partners across the organization to garner support for network contracting activities to ensure all aspects of operational implementation are completed on a timely and accurate basis.
 
MAJOR RESPONSIBILITIES
Primary Responsibilities:
* Strong emphasis on physician partnerships and contract negotiations
* Experience in fee schedule development
* Experience in negotiating rates with providers
* Provide timely responses to requests for demographic updates and investigation of issues
* Support affordability initiatives through provider education, outreach and tracking
* Provider Data integrity research, analysis and outreach as needed
* Network restructuring initiatives: network analysis, provider communications
* Prioritize and organize own work to meet deadlines
* Data Management for provider information is a key responsibility and requires attention to detail
* Knowledge of Medicare, Medicaid and Health Exchange plans
* Proficiency in analyzing, understanding and communicating financial trends
* Knowledge of claims processing and guidelines
* Excellent written and verbal communication skills
* Experience presenting to varied audiences
* Ability to manage multiple priorities in a fast-paced environment
* Driver's license and vehicle are required
Preferred Qualifications:
* Experience in Contract Management systems
* Knowledge of claims processing systems and guidelines
* Experience in performing/evaluating network adequacy analysis
* Strong interpersonal skills, establishing rapport and working well with others
* Experience in a contract role handling complex network agreements with accountability for business results
* Knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • Bachelor's Degree; Master Degree Preferred; or, 10+ years of relevant experience
  • Knowledge of Microsoft Office applications
  • Knowledge of Microsoft Office applications  
  • 3+ years of experience in contracting
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