Description:Provider Contracting Specialist
It’s a great time to put the strength of Coventry Health Care behind your career!
Coventry Health Care is a $12 billion growth oriented national managed health care company based in Bethesda, MD with 14,000 employees in 48 states. We provide a full range of risk and fee-based managed care products and services to a broad cross section of employer and government-funded groups, government agencies, and other insurance carriers and administrators.
Coventry is currently seeking a Provider Contracting Specialist to work with our corporate Network Development team. This position will be located in our Scottsdale, AZ office.
In the role as Provider Contracting Specialist you will assist with managed care contracting with physicians and ancillary providers for all contracts pertaining to fully insured, Health Plan, PPO, corporate accounts, lease networks and workers’ compensation; perform ongoing network analysis; recruit and contract with individual providers who meet established selection criteria to assure adequate geographic and specialty coverage and make recommendations for retention or delistment of providers.
The ESSENTIAL RESPONSIBILITIES of the Provider Contracting Specialist will be:
- Research, analysis, and negotiation support of contract agreements for all contracts pertaining to fully insured, Health Plan, PPO, corporate accounts, lease networks and workers' compensation.
- Develops and implement a formal, documented ongoing program to ensure good communications with all physicians and other providers.
- Assist managers and staff in planning, recruiting and implementing the physician and hospital network.
- Assist managers and staff with the development and monitoring of provider contracts; prepare and evaluate reports regarding the provider network.
- Manage the addition and termination of providers into the network; ensure the accuracy of provider data entered into the provider database.
- Perform other duties as required.
Qualifications: The ideal Provider Contracting Specialist will possess the following:
- Bachelor's degree or equivalent experience.
- Previous (usually 3+ years) experience in provider contract negotiation.
- Substantive knowledge of managed care policy and direction.
- Knowledge of ICD-9 and CPT codes desired.
This position requires excellent communication, negotiation, analytical and problem solving skills and the ability to work in a fast paced environment.
CHC offers an excellent compensation and benefits package including medical, dental, vision, and 401k. If you are a results oriented individual who is willing and able to make a difference, please submit your resume & salary requirements to our online Career Center at
http://jobs.coventryhealthcare.com/ (reference job requisition number
1310143)
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Scottsdale, AZ, US
Organization: 40040 - FHGC - Provider Network Admin
Schedule: Full-time
Job Posting: 2013-01-14 00:00:00.0
Job ID: 1310143
