Contract Negotiator III Details

Contract Negotiator III

Health Net of California - Rancho Cordova, CA

Employment Type : Full-Time

Health Net of California and Centene Corporation are hiring for a Contract Negotiator III in/near our Sacramento office.

Qualified applicants will have proven experience with Health Plan contracting and negotiation. The will have excellent communication skills, both written and verbal and will understand how providers, members and the Health Plan utilize the product(s).
Medi-Cal and Excel experience is also highly desired.

Apply today as interviews will be conducted asap!

Additional duties and responsibilities are as follows:

• Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State guidelines. Ensure that all necessary documentation and information are included.
• Lead assigned recruitments (i.e., physician, hospital and ancillary) and ensure they result in complete and accurate standard contracts that meet objectives
• Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication
• Initiate contact and identify potential providers by geographic and specialty needs and update database
• Coordinate with internal departments and contracted providers to implement and maintain contract compliance

Education/Experience:Bachelor’s degree in Healthcare Administration, Business Administration, Finance, related field or equivalent experience. 4+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician’s office/group setting. Working knowledge of State and/or Federal health care programs preferred (Medicaid, Medicare).

Key Words: Contract, Contracting, Medicare, Medicaid, Medi-Cal, Network Providers, Network, Networking, Provider Network, Provider Relations, Healthcare, MCO, Managed Care, Operations

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.