Now hiring Network Contract Manager I

The Provider Network Specialist is responsible for identifying network expansion opportunities and facilitating key recruitment related activities. The Provider Network Specialist drafts, reviews, negotiates and finalizes standard provider agreements, which includes but is not limited to single financial agreements based on sound analytical principles and approaches. The Provider Network Specialist provides implementation and ongoing support to Value Based Reimbursement and Value Based Program providers. The NCM I work assignments involve a low to moderately complex of variable factors. Work with minimal guidance; seek guidance on complex tasks.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us:
• Full Time - Exempt: Yes
• Job is based Cooper Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

• High School Diploma required.

• 1 to 3 years of progressive network management experience including provider contracting and network administration in a healthcare organization.

• Experienced in negotiating managed care contracts with physician groups, ancillary providers and hospital systems.

• Basic Knowledge of Medicare reimbursement methodologies.

• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

• Excellent written and verbal communication skills

• Ability to manage multiple priorities in a fast-paced environment. Proficiency in MS Office applications

• Must be passionate about continuously improving provider experiences

• Use various department input and feedback, network adequacy reports, including competitive network analysis, etc., to identify network gaps in existing assigned networks and recruit providers so networks remain competitive and compliant with state and federal regulations.
• Collaborate with team and create strategies for meeting network growth.
• This position prepares, analyzes, reviews and projects financial impact of provider contracts prior to and/or during external negotiation.
• Specific responsibilities include but are not limited to: strategic positioning for network development, monitoring financial performances, and ensuring compliance with contracting guidelines.
• This position involves a high degree of personal interaction with the management team, as well as providers and other health plan staff.
• Position requires ability to facilitate and present complex ideas at inter-department meetings to ensure proper interpretation and configuration of contracts.
• Demonstrates a knowledge and understanding of providers to present and make recommendations regarding network needs, looking always to expand the network to support profitable market growth.
• Responsible for interpreting and explaining issues related to contracting and provider payment methodology.
• Coordinate with Configuration and Testing Department the prioritizing of contracting requests. Work closely with Contracting Audit with PHP Audit Department and ensure proper configuration of those scheduled contracts.
• Travel as required to meet with providers for purposes of recruitment and contracting related meetings.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

USD $36.48/Hr.

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

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