What are the responsibilities and job description for the Provider Network Contractor position at EWINGS INC.?
EWINGS is seeking mid and senior-level hospital contractors to help build a robust provider network backed by a 5-Star Medicare Advantage plan serving Ohio communities.
It is our strong preference to work with contractors who reside in the area and have recent experience working with Cleveland Clinic, University Hospital, and Mercy Hospital.
Provider outreach will begin in August and will conclude in February of 2023. For top-producers there is opportunity to continue contracting through the subsequent network build phases which will continue through 2023.
Some of our most vulnerable populations rely on Medicare for their healthcare needs. Join our team in building this new network for Memphis seniors!
PROJECT HIGHLIGHTS
- Initial 5-month contract
- Telecommute based, but prefer contractors who are open to visiting local providers
- Hourly reimbursement starting at $55/hr for mid-level contractors, depending on skillset, experience, and remaining positions available at mid and senior levels (limited slots available)
PROJECT REQUIREMENTS
- 1 years' experience contracting with Memphis providers
- Available to complete a six-month contract.
- 3 years of experience in a healthcare network development, network contracting, account management, provider services, provider contracting, etc.
- 3 years of experience in network fee schedule development using actuarial models.
- 3 years of experience utilizing financial models and analysis in negotiating network rates.
- 3 years of experience in performing network adequacy and network gap analysis.
- Intermediate level of knowledge of claims processing systems and guidelines.
PRIMARY PROJECT GOALS
- Evaluate and negotiate contracts with healthcare providers in compliance with contract templates, reimbursement structure standards, and other key process controls.
- Establish and maintain relationships with healthcare providers and ensure the network composition includes an appropriate distribution of provider specialties.
- Provide explanations and interpretations for the provider network roster within your area of expertise.
- Receive provider phone calls and answer questions as appropriate.
- Resolution of contract loading issues.
Other Keywords: Provider Network Contracting, Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Facility Contracting, Provider Network, Network Development, Provider Services, Associate Director, Contract Negotiating Negotiation, Network Management, Accountable Care Organization (ACO), Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, WFH
Job Types: Full-time, Contract, Temporary
Pay: From $55.00 per hour
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: Remote