Healthcare Provider Network Contractor

Reference # :20-00019Title :Healthcare Provider Network ContractorLocation :Dickinson, NDExperience Level :Start Date :06/02/2020 DescriptionEWINGS is in search of Healthcare Provider Network Contracting professionals for a potential Medicare Advantage build in North Dakota.POSITION DESCRIPTION: Network Contractor - Develop a provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance, trend management, and produces an affordable and predictable product for customers and business partners. Provider network contractor will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining relationships with providers ensuring the network composition includes an appropriate distribution of provider specialties, in this role, you will be expected to identify solutions to non-standard requests and problems, solve moderately complex problems and/or conduct moderate analyses. QUALIFICATIONS:

It is required that candidates have extensive experience working with healthcare providers in North Dakota.

It is preferred that candidates reside in North Dakota.

4+ years of experience in a network contracting-related role.

Managed care work experience contracting or recruiting a range of healthcare providers including physicians, hospitals, specialists, ancillaries.

In-depth knowledge of reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) preferred.

At least an intermediate level of knowledge of claims processing systems and guidelines.

4+ years of experience in performing network adequacy analysis.

Intermediate level of experience with MS Excel required.

Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.

Strong interpersonal skills, establishing rapport and working well with others. Experience working in a high performing team environment that focuses on productivity and achieving results.

IMPORTANT: Consultants will be engaged as Independent Contractors working for EWINGS, INC. When applying please provide the date of when you would be available to start a new assignment.HIRING PROCESS OVERVIEW: Interview with EWINGS Recruiter; Interview with EWINGS; Reference Check; Background Check; Onboarding with EWINGS; Orientation with client. We look forward to potentially working with you! EWINGS, INC. www.ewingsinc.com