Randstad is seeking a direct hire Contract Negotiator to coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi specialty groups) and ancillary service agreements that are in accordance with corporate, health plan and State guidelines. The ideal candidate will posess 2+ years of contracting, provider relations or other related experience preferably in a healthcare, managed care, or insurance related environment. License/Certification: Valid driver's license.
- Recruit and develop provider network plan for region and set of providers
- Identify and initiate contact with potential providers
- Negotiate contracts
- Leads assigned negotiations (i.e., hospital, physician and ancillary) and ensure that negotiations result in the unit cost targets expected and meet the objectives of the company and approximate the State’s reimbursement to the provider
- Facilitate and provide oversight to the provider set-up and contract configuration to ensure accurate claims adjudication
- Evaluate and monitor providers’ performance standards and financial performance of contracts.
- Assist with and track credentialing activities
- Facilitate the organization of provider focus groups
- Coordinate with internal departments and contracted providers to implement and maintain contract compliance
- Contract Law
- Contract Negotiation
- Contract Maintenance/Renewal
- Years of experience: 2 years
- Experience level:Experienced
Working hours: 8 AM - 4 PM
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