Ewings Associates, Inc. Provider Network Contractor in Augusta, Maine

Reference # :18-00001Title :Provider Network ContractorLocation :Augusta, MEPosition Type :ContractExperience Level :5 YearsStart Date / End Date :06/04/2018 / 11/30/2018 Description

Healthcare Provider Network Development Contractor. EWINGS, INC. is in search of a healthcare network development professionals with local market experience. CANDIDATES MUST BE AVAILABLE TO START BY JUNE 4, 2018. This is a temporary, telecommuting assignment that is scheduled to last 6+ months.DISCLAIMER: This opportunity is dependent on our client winning a major contract with the federal government to be announced in early June. Applications are being accepted as preparation for a potential engagement.POSITION DESCRIPTION: Develop a provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners.Provider network contractor will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with providers ensuring the network composition includes an appropriate distribution of provider specialties, in this role, you will be expected to identify solutions to non-standard requests and problems, solve moderately complex problems and/or conduct moderately complex analyses and work with minimal guidance in a telecommuting compacity.QUALIFICATIONS: It is very important that candidates have experience working with providers in the local market. Undergraduate degree, 4+ years of experience in a network management-related role, such as contracting or provider services on programs such as the Veterans Health Administration Community Care program, Department of Defense healthcare program Tricare, Medicaid and Medicare. Managed care work experience contracting or recruiting a range of healthcare providers including physicians, hospitals, specialists, ancillaries. In-depth knowledge of reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) preferred 3+ years of experience utilizing financial models and analysis in negotiating rates with providers. At least an intermediate level of knowledge of claims processing systems and guidelines. 3+ years of experience in performing network adequacy analysis. Intermediate level of experience with MS Excel required. Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. Strong interpersonal skills, establishing rapport and working well with others. Experience working in a high performing team environment that focuses on productivity and achieving results.Consultant will be a 1099, hourly Independent Contractor working for EWINGS, INC.DISCLAIMER: This opportunity is dependent on our client winning a major contract with the federal government to be announced in June. Applications are being accepted as preparation for a potential engagement.