Provider Contracting Director jobs in Tallahassee, FL

Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Healthcare Provider Relations / Contracting Representative (Remote/On-the-Road)
  • Alivi
  • Tallahassee, FL FULL_TIME
  • SUMMARY
    The Network Development Representative focuses on building Specialty Benefits Networks across multiple Markets/States considering cost negotiations and adequacy to support expected membership volume by Levels of Service. The position will support the Specialty Benefits Networks with growth objectives and analytical analysis to ensure company strategies for expansion are adequate to meet contract demands for each respective Market/State. The position coordinates with Provider Leads to complete contracting with identified Specialty Benefit providers. 
    DUTIES & RESPONSIBILITIES
    • Target potential providers to establish contractual agreements.
    • Thoroughly understand Alivi’s Corporate Playbook and always ensure alignment with the     playbook in all day-to-day activities.
    • Work directly with strategic leaders of the company to ensure strategic support for expansion efforts and ability to administer contract arrangements with Health Plans/Payers in Medicare, Medicaid and Commercial lines of business. 
    • Travel to provider offices as needed to secure Specialty Benefit provider contracts.
    • Support Alivi’s business development, corporate growth strategy and goals as needed. 
    • Recruit, negotiate, contract and re-contract with Specialty Benefit providers at all ‘Levels of Service’ to ensure quality, cost effectiveness and their participation in all products.
    • Support contracting efforts for new products/risk strategies and help develop new service areas and negotiating with new providers.
    • Support in the development of strategic initiatives relating to provider networks, including service area expansions, new payment and incentive methods, risk arrangements and new products.
    • Work with provider relations team to develop and maintain a comprehensive provider network (hospitals, physicians, ancillary) that meets CMS access standards and deliver a full range of healthcare services to our members.
    • Analyze, plan, and assure provider network adequately meets all CMS access standards across all geographic areas.
    • Communicate internally and externally regarding all provider related issues. Participate in key committees throughout the organization.
    • Act as a liaison between Alivi and contracted health plans concerning all aspects of Specialty Benefit provider network participation. 
    • Supports Credentialing Department by assisting with the collection of physician credentials for newly contracted providers.
    REQUIREMENTS
    • Associates Degree preferred.
    • 1 to 2 years experience with Specialty Benefit providers and downstream provider contracting. 
    • Knowledge of provider reimbursement strategies for Managed Care, government products and commercial products.
    • Must have a valid driver’s license.    
    • Must be able to pass DMV record check.  
  • 1 Day Ago

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Project Manager - Construction/Contracting 3
  • Actalent
  • Tallahassee, FL OTHER
  • Fortune 500 Project Manager Opportunity Now!Description:The Construction Project Manager is responsible for project financials, administration, implementation, management, and customer satisfaction fo...
  • Just Posted

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Heavy Equipment Operator
  • Davidson Contracting
  • Tallahassee, FL FULL_TIME
  • Responsibilities:- Operate various types of heavy equipment, including bulldozers, concrete mixers, tankers, backhoes, Caterpillar machines, front loader trucks, and dump trucks- Perform equipment ins...
  • 14 Days Ago

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Field Service Technician
  • Westwind Contracting, Inc.
  • Port Saint Joe, FL FULL_TIME
  • About us Westwind contracting has been in business for over 38 years. It is a family owned and operated with construction sites within the state of Florida. Job Overview: We are seeking a skilled and ...
  • 1 Day Ago

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Asphalt Plant Maintenance Tech
  • CWR Contracting, Inc.
  • Tallahassee, FL FULL_TIME
  • ASPHALT PLANT MAINTENANCE TECH C.W. Roberts Contracting, Inc. (CWR) is a growing road construction company. We are seeking to fill an Asphalt Plant Maintenance Tech position for our Tallahassee asphal...
  • 8 Days Ago

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Project Manager
  • CWR Contracting, Inc.
  • Hosford, FL FULL_TIME
  • C.W. Roberts Contracting, Inc. (CWR) is a growing road construction company. We are seeking an experienced Project Manager for our area operations. This position requires 5 years of private and public...
  • 1 Month Ago

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0 Provider Contracting Director jobs found in Tallahassee, FL area

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Building Inspector
  • Leon County, FL
  • Tallahassee, FL
  • Salary : $47,486.40 - $78,332.80 Annually Location : DSEM - 435 N. Macomb St. Tallahassee, FL Job Type: Career Service F...
  • 5/10/2024 12:00:00 AM

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Child Care Provider - TMH's Childcare Care
  • Tallahassee Memorial Healthcare
  • Tallahassee, FL
  • WHO WE ARE & WHAT WE DO: Tallahassee Memorial HealthCare (TMH) is a private, nonprofit community-based healthcare system...
  • 5/9/2024 12:00:00 AM

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Speech Therapist/Flex - Rehab Pediatrics
  • Tallahassee Memorial Healthcare
  • Tallahassee, FL
  • WHO WE ARE & WHAT WE DO: Tallahassee Memorial HealthCare (TMH) is a private, nonprofit community-based healthcare system...
  • 5/9/2024 12:00:00 AM

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Building Inspector
  • Leon County BOCC
  • Tallahassee, FL
  • Salary: $47,486.40 - $78,332.80 Annually Location: DSEM - 435 N. Macomb St. Tallahassee, FL Job Type: Career Service Ful...
  • 5/9/2024 12:00:00 AM

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In-Shop Team Member: Hiring Now!
  • Jimmy John's Gourmet Sandwiches
  • Tallahassee, FL
  • Jimmy John's is unlike any other sandwich chain in the country because we specialize in super-fast, high-volume sandwich...
  • 5/9/2024 12:00:00 AM

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Crew Member
  • Chipotle
  • Tallahassee, FL
  • Crew Member (24008283) Description CULTIVATING A BETTER WORLD Food served fast doesn't have to be a typical fast food ex...
  • 5/9/2024 12:00:00 AM

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Speech Therapist HHC
  • Tallahassee Memorial Healthcare
  • Tallahassee, FL
  • WHO WE ARE & WHAT WE DO: Tallahassee Memorial HealthCare (TMH) is a private, nonprofit community-based healthcare system...
  • 5/7/2024 12:00:00 AM

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In-Shop Team Member: Hiring Now!
  • Jimmy John's
  • Tallahassee, FL
  • Jimmy John's is unlike any other sandwich chain in the country because we specialize in super-fast, high-volume sandwich...
  • 5/6/2024 12:00:00 AM

Tallahassee (/ˌtæləˈhæsi/) is the capital city of the U.S. state of Florida. It is the county seat and only incorporated municipality in Leon County. Tallahassee became the capital of Florida, then the Florida Territory, in 1824. In 2017, the population was 191,049, making it the 7th-largest city in the U.S state of Florida, and the 126th-largest city in the United States. The population of the Tallahassee metropolitan area was 382,627 as of 2017[update]. Tallahassee is the largest city in the Florida Panhandle region, and the main center for trade and agriculture in the Florida Big Bend and S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$155,794 to $225,015
Tallahassee, Florida area prices
were up 1.5% from a year ago

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