Job ID: J121306
Company: Gateway Health Plan
Location: Home, AR, United States
Facility: Work From Home
Full/Part Time: Full time
Job Type: Regular
Posted at: Apr 16, 2018
This job functions as the Dir Provider Contracting for the Arkansas (Forevercare) line of business and is responsible for directing negotiation of the plan’s key contracts with health care providers (hospitals, PHOs, physicians, intermediate care providers). Directs financial analyses of the provider’s payment history, develops approaches to manage the payout consistent with company parameters, oversees the actual negotiation process, and assumes the lead where necessary. Responsible for the development, implementation, maintenance, and updating of the plan’s multiple fee schedules and payment methodologies used to reimburse institutional and professional providers. Implements network contract and reimbursement initiatives as indicated by enterprise and market strategy.
compliance or other reimbursement-related issues.
LICENSES AND CERTIFICATIONS
Language (Other than English)
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
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