Job Summary

• Bachelor Degree and 5 years provider contracting experience OR 9 years managed care experience including 5 years provider contracting experience.

• Extensive knowledge of provider and facility contracting, products, and claims/processing systems.

• Leadership skills to oversee staff, implement initiatives, and work across the company to resolve issues.

• Negotiation skills.

• Relationship building skills.

• Knowledge of marketplace.

• Meet deadlines and work well under pressure.

• Verbal and written communication skills to interact with all levels of corporate personnel and providers.

• PC proficiency to include Microsoft Office.

• Analytical skills

• Project management skills to lead or participate in projects or initiatives.

• Ability and willingness to travel within assigned areas of responsibility, including overnight stays

Preferred Job Qualifications & Additional Details:

• Previous HEDIS and/or CMS STARs experience

• Solid understanding of health insurance, customer messaging/design and project management

• Expert level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.).

• Experience in financial/trend analysis

• Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results.

• Client-site Location: This is a field based position in the Pennsylvania/Philadelphia market, primarily Manayunk, Conshohocken, Plymouth Meeting & Pottstown. The individual will be onsite at provider offices typically 3 days a week and work from home 2 days a week.

• Schedule: Monday - Friday, typical business hours with infrequent evening and weekend meetings.

• Sponsorship: Sponsorship is not available