Medicare Advantage Contracting Administrator – Hospitals/Ancillaries

SUMMARY:

The Medicare Advantage Contracting Administrator (Provider Contracting SR Specialist) is responsible for network development, contracting, and relationship management with hospital and ancillary providers.

Requires local travel to network providers
Coverage area – Atlanta and surrounding counties
Car & valid driver’s license required (mileage reimbursement provided)

RESPONSIBILITIES:

Responsible for the general oversight of the hospital and ancillary network in assigned territory, to include financial performance, quality initiative performance, provider data accuracy, trend analysis, and provider engagement.
Provides support to hospital and ancillary providers to include assistance with issues, orientation to the network, and other services, as required.
Leads hospital and ancillary contract negotiations for assigned relationships.
Organizes, participates in and/or can be expected to lead network and company meetings, to include Joint Operating Committee meetings.
Expected to collaborate with physician network administrators and senior leadership to develop a strategic plan for assigned territory and execute on that plan.
Presents at monthly financial review to senior management.
Serves as the network adequacy lead for the Georgia market.
Supervises at least one staff member responsible for accurate provider data across health plan platforms