Network Health WI

Manager

• Successfully manages the Managed Care Contracting prospective, renewal and termination negotiation processes as they relate to: Network Health, HMO/POS; third party administrators and self-funded employers, Accountable Care Organizations (ACO).
• Accountable for establishing and maintaining positive relationships with internal departments, Network Health executive leadership and for any of the following prospective and/or existing external group: Network Health HMO/POS and third-party administrators.
• Serves as the individual accountable for the overall relationship between Network Health and selected contracted providers.
• Specific duties include establishing the initial contact with contracted providers setting and/or maintaining the tone for the desired Network Health provider agreements.
• Conducts managed care contracting related research and analysis including developing compensation/reimbursement structures and contract terms/conditions.
• Evaluates best-fit options for continued negotiations.
• Prepare executive summaries and recommendations.
• Initiates contract implementation process.
• Maintains effective communication throughout contract terms and communicates contract updates and changes as needed.
• Requests audits from the Provider File Specialist and evaluates contracting terms.
• Provides leadership for department, and Network Health special projects

Contract Manager