Provider Network Executive IV

Job Summary

A company is looking for a Provider Network Executive IV.

Key Responsibilities:

• Develop and execute ongoing account management and service strategy to meet corporate strategic/financial objectives
• Lead negotiation and implementation of complex, multifaceted provider contracts
• Collaborate with Healthcare Economics in rate development and proposal analysis

Required Qualifications:

• Bachelor’s Degree or (4) years of experience in a provider or payer environment
• (6) years of experience in payer or provider contracting and managing provider relationships in the health care or insurance industry including (4) years of experience negotiating contracts
• Master’s Degree in a related field preferred
• Consulting experience preferred
• Working knowledge of the Health Insurance Portability and Accountability Act (HIPAA), the National Committee for Quality Assurance (NCQA), government health care programs, and risk coding