Senior Provider Contract Specialist at Bright Health
- Lead the development of provider contracting efforts from start-to-finish, including but not limited to process oversight, strategic diligence, outreach, and contract negotiations with regards to mid-sized and large hospitals and health systems, large and small physician groups and ancillary providers to execution
- Effectively negotiate rates, structures, and contract language with a range of provider types across multiple geographies
- Support collaboration with our Care Partners to analyze, design, and develop networks through ongoing evaluation of both current and potential network participants
- Support and enhance Bright Health’s portfolio of strategic national and multi-regional network partnerships to compliment local network development efforts
- Manage ongoing network participation and performance, including performance analytics and management, as well as contract renewals and terminations
- Partner with stakeholders across the organization including, but not limited to sales, finance, regulatory, medical management to drive strategic priorities and initiatives
- Monitor utilization trends for non-participating providers and execute on organizational strategies to ensure members are seeking care with participating providers when appropriate
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor's Degree in business, economics, healthcare administration, or a related field is preferred.
- At least four (4) years of experience, with at least five (5) years of experience in network development, network management, or reimbursement model design required
- Experience with successfully executing and implementing payer-provider contracts or partnerships required.
- Experience with developing, presenting and analyzing various types of financial analyses in order to make informed strategic decisions preferred.
- Desire and ability to move quickly between strategic leadership, tactical execution, and managing analytics
- Knowledge of managed care practices and procedures, specifically in contracting language and negotiations. Provider relations is preferred
- Ability to effectively engage providers, ranging from national providers to regional integrated delivery systems to local physician practices
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures
- Excellent multitasking and prioritization skills with a proven ability to manage multiple projects in parallel to completion
- Superb written and verbal communication skills with an ability to effectively collaborate with internal and external executive leadership