Provider Contract Networking Supervisor
Company: Insight Global
Location: Renton
Posted on: June 24, 2022
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Job Description:
The Contract Network Supervisor is responsible for the continued
development and implementation of the Network Management Plan per
URAC and DoD guidelines. Understands the attitudes and values of
the community and establishes effective working relationships with
stakeholders to increase resources and collaboration Responsible
for assuring providers and network members are educated in Health
Plan criteria and processes and acts as the primary resource for
orientation and coaching for performance improvement. Responsible
for a key role in provider contracting and network relations. Acts
as a representative and spokesperson for US Family Health Plan both
internally and externally. Maintains ongoing contact with providers
through on-site visits, phone and written communications.
Communicate effectively with internal constituents on reimbursement
strategies, mechanisms to improve payer compliance, and to
communicate status and outcomes of negotiations. Utilizes knowledge
of the medical community to source medical groups for the USFHP
network. Evaluates the appropriate medical groups, and makes
recommendations to management about which groups to include. Leads
contact negotiations and completes the contracting process with new
network providers and assures the successful implementation of
negotiated contracts. Responsible for the Health Plans non-clinical
utilization management program referral management, and providing
education and oversight to the clinic based referral coordinators.
Communicate effectively with internal constituents on reimbursement
strategies, mechanisms to improve payer compliance, and to
communicate status and outcomes of negotiations.- BA Degree in
related field- Ambulatory Medicine- Project Management/Account
Management- 3+ years of federal health plan contract knowledge
(medicare, medicaid, TriCare, DOD, URAC etc)- Strong personality
(outgoing and relationship focused)- Extensive experience
understanding contracted networks and government health plans- High
School Diploma or GED Required
Keywords: Insight Global, Renton , Provider Contract Networking Supervisor, Other , Renton, Washington
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