The Sr. Provider Network Manager develops the provider network through rigorous research, issue/gap identification, contract negotiations, relationship development, and servicing.
Primary focus of this role is unit cost management via contracting and negotiating contract terms.
Typically works with the most complex providers.
Contracts involve non-standard arrangements that require a high level of negotiation skills.
Fee schedules are customized.
Projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
Conducts more complex negotiations and drafts documents.
Prepare financial projections and conduct analysis.
Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
Works independently and requires high level of judgment and discretion.

Requires a BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills/Experience/Education: Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Strong experience conducting thorough research and applying well-reasoned judgment to inform decisions.
Experience building strong cross-functional relationships to ensure timely resolution of escalations.
Experience in fee schedule development using actuarial models strongly preferred.

Senior Provider Network Manager

Key skills