Provider Contracting Manager jobs in New Jersey
Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Recently Added Provider Contracting Manager jobs
Provider Contracting Senior Advisor - Hybrid
- The Cigna Group
-
Morris, NJ
FULL_TIME
-
This is a hybrid position which will require a weekly schedule of: 3 days working either in office or traveling to in-person meetings with Providers and 2 days working at home/remote.
Summary
National Contracting plays a significant role in The Cigna Group's Enterprise Affordability strategy. The LifeSOURCE Transplant Network managed by National Contracting is a key growth opportunity for Cigna and play a critical role in delivering affordability and network access for our Customers and Clients. LifeSOURCE consists of over 180 contracted facilities and represents roughly $1B in annual medical spend across US Commercial and US Government and growing. Heavy focus on controlling unit costs and trends in these contracts are critical for Cigna to achieve Affordability goals.
The Provider Contracting Senior Advisor is a key role in supporting the company's overall affordability programs, which directly address customer and client demands for lower cost and higher quality of care. This role will report to the Provider Contracting Director - LifeSOURCE and is accountable for the management of contracting and network management activities for the Northeast region.
Job Components And Deliverables
DRIVING AFFORDABILITY AND GROWTH- Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain LifeSOURCE’s competitive position
- Partners with Medical Economics to develop and present affordability opportunities using medical, claims data, financial, and other internal/external data
- Incorporates Industry/Competitive trends in programs/contracts
- Partners with local markets to drive network adequacy and membership growth/persistency strategies
- Partners with Payor Solutions operations to drive new revenue opportunities using the LifeSOURCE network across applicable lines of business
- Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
- Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
- Manages increasingly complex contracts and negotiations for transplant and advanced cellular therapy with sophisticated hospitals and physician groups for the assigned geographies.
- Proactively builds relationships that nurture provider partnerships to support the LifeSOURCE strategy
- Negotiates rates and terms on new and existing provider agreements
- Creates LifeSource agreements that meet internal operational standards and external provider expectations
- Identifies and targets new providers to bring in network
- Incorporates contract and compliance standards into provider agreements updates including use of a variety of reimbursement methodologies (fee-for-service, capitation, case rate, DRG, outcomes based adjusted, pay for performance, RBRVS)
- Responsible for contractual/financial performance of LifeSource provider agreements
- Mitigates risk associated with provider performance and termination
- Serves as single point of accountability for business relationship to Markets, Product, Clinical, Service Operations,
- Drives education and advocacy across markets and other internal matrix partners
- Contract language interpretation and document preparation to ensure accurate implementation and administration
- Bachelor’s Degree in Finance or related field highly preferred
- 5 years of Commercial Contracting and Negotiating experience involving complex delivery systems and organizations
- Strong understanding and experience with hospital, managed care, and provider business models
- Knowledge of transplant hospital contracting is preferred
- 25% regional travel required
- Detailed knowledge of Affordability initiatives and medical spend categories
- Superior problem solving, decision-making, negotiating skills, contract language and financial acumen
- Experience in developing and managing key provider relationships, including senior executives
- Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization
- Knowledge and use of Microsoft Office tools
For this position, we anticipate offering an annual salary of 106,400 - 177,300 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. - 2 Days Ago
Manager, Revenue & Contracting Operations
- HMH HOSPITALS CORPORATION
-
Edison, NJ
FULL_TIME
- Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in c...
- 1 Month Ago
Contracting
- Formosa Plastics Corporation, U.S.A
-
Livingston, NJ
FULL_TIME
- Job Description : This petro-chemical industry Buyer position exists to perform the assigned Purchasing work to solicit the most competitive quotes in the most efficient and effective manner, reduce c...
- 20 Days Ago
Manager, Medicaid Contracting & Rebate Administration
- Novartis Group Companies
-
East Hanover, NJ
FULL_TIME
- Job Description SummaryLocation: East Hanover, NJ (Hybrid)#LI-HybridAbout the role: Manage operations of the Medicaid Rebate department in an effort to provide prompt, accurate and compliant payment o...
- 3 Days Ago
Business Development Manager
- Beacon Electrical Contracting
-
Scotch Plains, NJ
FULL_TIME
- Job DescriptionBeacon Electric is interested in hiring a Business Development Manager to join our team! You will be responsible to find new clients and help move our business to the next level!Respons...
- 2 Days Ago
Retail Program Manager
- W. Danley Electrical Contracting
-
Monroe, NJ
FULL_TIME
- Overview Retail Sales Manager Looking to TRADE up to a better opportunity? Walter Danley has an exciting opportunity for an in-Store Sales Manager. We are building a team of top-notch marketers to wor...
- 13 Days Ago
Provider Contracting Manager jobs at Popular Companies
Associate Manager - Contract Management
- Novo Nordisk
-
Plainsboro, NJ
- About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse an...
- 6/11/2024 12:00:00 AM
Contracts Manager
- Inari Medical, Inc.
-
Irvine, CA
- Description The Contracts Manager, working independently, closely collaborates with the finance, legal, compliance, and ...
- 6/11/2024 12:00:00 AM
Manager - Contract Management and Payer Variance
- ChristianaCare
-
Wilmington, DE
- Are you looking for a career opportunity with growth potential at a healthcare organization that is based on excellence ...
- 6/11/2024 12:00:00 AM
Provider Contract Management Specialist
- Naphcare, Inc.
-
Birmingham, AL
- Overview: NaphCare has an excellent opportunity for a Provider Contracting Specialist to join our Regional Office in Pho...
- 6/10/2024 12:00:00 AM
Manager Contract Management
- McDermott
-
Houston, TX
- Job Description Company Overview: People power our future. That is why advancing a dynamic, inclusive environment, where...
- 6/10/2024 12:00:00 AM
Associate Provider Contract Manager
- Kaiser Permanente
-
Burbank, CA
- Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
- 6/7/2024 12:00:00 AM
Senior Provider Contract Manager
- Kaiser Permanente
-
Oakland, CA
- Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
- 6/7/2024 12:00:00 AM
Senior Manager-Contract Management, Americas
- Idaho State Job Bank
-
Boise, ID
- Senior Manager-Contract Management, Americas at Marriott in Boise, Idaho, United States Job Description Job Number 24034...
- 6/7/2024 12:00:00 AM
About New Jersey
New Jersey is bordered on the north and northeast by New York (parts of which are across the Hudson River, Upper New York Bay, the Kill Van Kull, Newark Bay, and the Arthur Kill); on the east by the Atlantic Ocean; on the southwest by Delaware across Delaware Bay; and on the west by Pennsylvania across the Delaware River.
New Jersey is often broadly divided into three geographic regions: North Jersey, Central Jersey, and South Jersey. Some New Jersey residents do not consider Central Jersey a region in its own right, but others believe it is a separate geographic and cultural area from the Nor...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$120,207 to $159,638
Most Popular Cities in New Jersey for Provider Contracting Manager Jobs
What does a Provider Contracting Manager do?
Provider Contracting Manager in Gastonia, NC
By simplifying and automating the provider contracting lifecycle, we help make it easier for health plans to identify and implement savings opportunities to obtain maximum value from provider relationships.
January 09, 2020
Provider Contracting Manager in Springfield, IL
Responsible for the oversight of their assigned networks to ensure network provider deficiencies are being met and working closely with their assigned Network Support staff and Medical Management counterparts to ensure network needs/changes are being effectively addressed and communicated both internally and externally.
January 19, 2020
Provider Contracting Manager in Cedar Rapids, IA
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
February 03, 2020