USA
1 day ago
Manager Provider Network Contracting
Your career starts now. We're looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com . ; **About this job:** Oversees provider contracting through direct or team oversight of provider contracting.; Primary functions include direct or team management of provider contracting and negotiating provider contract terms. Assists the Director in risk, capitated, and value-based contract arrangements.; **Responsibilities:** + Negotiating and contracting complex provider agreements + Management of designated provider contracting staff, including oversight of contracting and negotiations and compliance with all Federal and State rules, regulations, policies and procedures, + Assist leader with developing and driving network management strategy related to network adequacy standards, marketable network, expanding risk, value-based, and capitated arrangements. + Responsible for assisting the Leader with departmental activities related to organization, regulatory, legal, and federal requirements or provider contracting initiatives. + Responsible for staffing decisions and managing the day-to-day activities of the; Provider Network Management Contracting Team. + Assist the department leader in monitoring and managing the provider network adequacy and accessibility. Establishing a priority list of new geographic locations and types of providers to be added to the business segment(s) service area/markets. + Participates in Organization, Plan, and/or physician committees as appropriate + Other duties assigned **Education & Qualifications:** + 7 or more years of provider contracts experience + A bachelor’s degree is required.; + 7 to 8 years of provider contract negotiations for health systems, hospitals, large professional groups, ancillary services, and ambulatory surgical centers + Experience negotiating all lines of business, Exchange/commercial preferred. + Experience negotiating new contracts, renewals, and amendments. + Experience in value-based, risk, or capitated arrangements is preferred. + Experience in management and leading a team. ; **Diversity, Equity, and Inclusion** At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy. **Our Comprehensive Benefits Package** Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
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