Provider Contracting Director jobs in Weirton, WV
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)
Recently Added Provider Contracting Director jobs
Manager, Provider Contracting Operations
- Health Partner Plans, Inc.
-
Pittsburgh, PA
FULL_TIME
-
Why Choose Jefferson Health Plans?
We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.
While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.
Perks of JHP and why you will love it here:
- Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing
- Flextime and Work-at-Home Options
- Benefits & Wellness Program including generous Time Off
- Impact on the communities we service
The Manager, Provider Contracting Operations oversees the Provider Contracting team operations, data and workflows. The Manager is responsible for managing the provider contracting end-to-end processes, which include the contract execution process, updates to the provider data systems, and tracking tools for all JHP contracts. In addition, the Manager creates and updates the department’s operating procedures and workflows. Finally, the Manager maintains and as required, updates the corporate provider contracting templates for all provider types.
As the Manager, Provider Contracting Operations, your daily duties may include...- Manage the Contract Operations team and processes, including tracking and monitoring standard and nonstandard contracts as they go through execution and implementation.
- Ensure that contract data and information are stored in the JHP contract management system.
- Manage the development and content of the hospital, professional and ancillary provider contract templates. Work closely with contracting, legal, and other stakeholders to ensure that all terms and revisions meet legal and regulatory requirements.
- Align and modify provider contracting templates to support JHP’s mission and business strategies.
- Manage contract renewal calendar and key event (e.g., increases, contract terms, unique provisions) tracking system.
- Develop and oversee departmental workflows and policies and procedures. Modify processes as needed.
- Update contract management system with information and data from executed provider contracts.
- Support network adequacy analytics with data and information from the contract management system.
- Perform job duties in compliance with policies and procedures of Jefferson Health Plans.
- Additional duties as assigned.
- Bachelor’s Degree or six years’ relevant experience
- 3-5 years of experience in a managed care or healthcare setting (payer or provider based), with experience in physician, ancillary and hospital contracting, healthcare or payer operations, provider recruitment, and/or claims payment.
- Preferred experience in management and/or leadership.
- Prior experience with a government programs health plan preferred, but not required.
- Superior verbal and written communication skills
- Strong negotiation, conflict resolution, organization, project management skills.
- Strong quantitative analytic abilities.
- Careful attention to detail.
- Ability to represent Health Partners Plans independently with external providers and senior level hospital and health system executives.
- Intermediate to advanced use of Microsoft Excel and Word, knowledge of current health care industry and knowledge of governmental program hospital/provider payment methodologies, sufficient to analyze cost and operational impact.
- Familiarity with claims payments processes and systems.
- 10 Days Ago
Provider Contracting Specialist
- Wexford Health
-
Pittsburgh, PA
FULL_TIME
- To Apply for this Job Click Here POSITION: Provider Contracting Specialist SCHEDULE: Full-Time (Monday-Friday 8:30AM – 5PM) FACILITY: Wexford Health Sources, Inc. Corporate Office LOCATION: Green Tree...
- 15 Days Ago
Practice Manager - Dental Site
- Provider Openings
-
Rochester, PA
FULL_TIME
- Position Overview The Practice Manager I will be responsible for supervision of our Rochester Dental site and will effectively carry out the Network’s Policies and Procedures while communicating manag...
- 8 Days Ago
Practice Manager - Dental Site
- Provider Openings
-
Rochester, PA
FULL_TIME
- Position Overview The Practice Manager I will be responsible for supervision of our Rochester Dental site and will effectively carry out the Network’s Policies and Procedures while communicating manag...
- 8 Days Ago
LCSW LPC
- Provider Openings
-
Rochester, PA
FULL_TIME
- At The Primary Health Network, we believe that every person deserves access to high quality healthcare services regardless of race, color, national origin, age, disability, sex or ability to pay. We p...
- 12 Days Ago
LCSW LPC
- Provider Openings
-
Clarion, PA
FULL_TIME
- At The Primary Health Network, we believe that every person deserves access to high quality healthcare services regardless of race, color, national origin, age, disability, sex or ability to pay. We p...
- 14 Days Ago
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0 Provider Contracting Director jobs found in Weirton, WV area
About Weirton, West Virginia
The city of Weirton is located at 40°25′N 80°35′W / 40.417°N 80.583°W / 40.417; -80.583 (40.41, −80.58). It extends from the Ohio border on the west to the Pennsylvania border on the east at a point where the northern extension of West Virginia is five miles across. Therefore, it is one of only three cities in the United States that borders two other states on two sides, and its own state on the other two sides, the others being Hancock, Maryland and Pittsburg, New Hampshire.
Weirton is across the Ohio River from Steubenville, Ohio, and about 35 miles west of Pittsburgh, Pennsylvania, along...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$168,031 to $242,681
Weirton, West Virginia area prices
were up 1.9% from a year ago
were up 1.9% from a year ago
What does a Provider Contracting Director do?
Provider Contracting Director in Modesto, CA
Learn more about our provider networks and the members our networks support.
December 17, 2019
Provider Contracting Director in Lafayette, LA
Informal Provider - Cares for children who are related to them and possibly children from one other family.
January 14, 2020
Provider Contracting Director in Battle Creek, MI
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
January 11, 2020