Provider Contractor Executive

The Provider Contractor Executive is responsible for identifying, recruiting, negotiating and contracting providers to join the Prime Health Services PPO network with a focus on workers’ compensation, commercial group health, auto liability, and personal injury with a focus on hospitals and health systems. 

What You'll Do

• Recruitment of Providers, ancillary facilities, hospitals and health systems via phone, email, or mail campaigns to negotiate PPO contracts for PHS Core business initiatives; ensuring contracts are cost effective and in compliance with all State, Federal, and corporate requirements
• Negotiate payment rates and payment terms for new and existing contracts within PHS corporate requirements including terms and conditions associated with State or Federal guidelines
• Successfully negotiates PPO contracts with large medical provider groups, independent hospitals, integrated care models, and health care systems
• Analyzes data to develop strategies for contracting and re-contracting
• Performs data analytics of proposed rates to ensure contracts for new and existing providers align with defined contracting guidelines
• Meets/exceeds daily call metrics, completion of negotiated contracts as defined by contracting leadership, which is subject to review and modification
• Manages and oversees assigned contracting tasks for specified geographic regions
• Ensures contract proposals are complete and accurate prior to sending information to the Provider for review and/or signature
• Establishes and maintains productive professional relationships with the Provider, hospitals, and health systems
• Enters progress reports and any notations regarding contracting efforts into PHS proprietary database
• Travel up to fifty percent (50%) may be required as needed to conduct stewardship meetings with Providers

What We're Looking For

• Bachelor’s Degree in Communications/Business or related field of study from an accredited college or university, or equivalent experience required
• 8+ years of managed care contract experience preferred
• Demonstrated negotiation skills and experience interfacing with C-Suite level contacts

Competencies

• Must be able to successfully work in a collaborative, deadline driven work environment
• Professional, friendly demeanor with excellent written and oral communication skills
• Flexible, adaptable, creative, organized, and self-motivated
• Must have strong negotiations and problem-solving skills and the ability to prioritize
• Strong customer service, public relations, and technical skills required, including Microsoft Office

Why You'll Love Working at Prime Health Services

• Medical Insurance (high deductible plan with an HSA)
• Dental Insurance
• Vision Insurance
• Short-term and long-term disability paid by the company
• Group term life paid by the company
• Generous PTO policy
• Employee recognition programs with monetary rewards
• Corporate office amenities
• Regular employee events

About Us

Prime Health Services (PHS) is a national medical cost containment company specializing in customized PPO network solutions. Since 2001, we’ve partnered with insurance carriers, TPAs, self-insured groups, and government entities to deliver high-quality healthcare access at discounted rates. Our technology-driven approach allows us to provide fast, flexible, and dependable service to our clients while supporting a collaborative, employee-focused workplace.