Provider Contracting Manager

Apply Description

COMPANY OVERVIEW

Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com.

POSITION OVERVIEW

The Sr. Network Manager will manage provider contracting and network development for all lines of business. The Sr. Network Manager is responsible for developing, executing, and maintaining a provider network strategy. Continuously evaluates network to ensure cost effective, optimal functionality. Works in concert with Sales & Marketing and Health Services in developing actions to meet market growth and medical cost targets.

ESSENTIAL POSITION RESPONSIBILITIES

Contracts and negotiates with Hospital, FQHCs, Physicians and Ancillary providers for all product lines

Conducts Provider Orientations and ongoing education to Network Providers

Understands and explains fee-for-service and risk contracts

Manages physician network by developing and maintaining relationships to drive business results within a specific geographic area

Responds to provider’s contract requests and inquiries

Analyzes network gaps and identifies providers to contract

Reviews and amends provider’s contracts when necessary

Evaluates contracted network to ensure functionality

Research and develop relationships with non-contracted providers

Collects credentialing and required documents for newly contracted providers

Performs special projects as assigned

Requirements

POSITION QUALIFICATIONS

Required Qualifications

Education/Experience:

Medicare Experience Preferred

3 - 5 years of experience in a Managed Care environment, Network Management or Provider Services

Hospital contracting experience or related Network Management position with the ability to perform the level of duties of the position

Demonstrated negotiation, analytic, and problem-solving skills

Experience or knowledge of provider reimbursement methods and claims processing systems

Verbal and written communications skills to include interpersonal and presentation skills

Ability to work effectively and independently. Demonstrated ability to effectively manage multiple priorities

HC70-20-106

Salary Description $84,000 - $94,000 yr, based on experience