Serve as primary relationship lead for assigned health plan partners
Own internal revenue and performance targets tied to your payer markets
Analyze operational and program data to identify risks and growth opportunities
Mae is a venture-backed digital health solution on a mission to improve the health and quality of life for mothers, babies, and those who love them. Mae has created a space where complete digital care meets culturally-competent on-the-ground support.
Analyzes new and revised hospital contracts, determines necessary actions, documents requirements, and establishes customer accounts.
Effectively communicates with external and internal customers throughout the contract process to ensure timely information reception.
Identifies opportunities and initiates process improvements, including written documentation in a process manual.
Pediatrix Medical Group is a physician-led organization and one of the nation’s largest providers of prenatal, neonatal, and pediatric services. They are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere.
Serve as the subject matter expert in interpreting payer agreements.
Collaborate with the Provider Network Operations team to support the build of standard operating procedures.
Maintain reconciliation trackers to measure contract performance and support audit requests.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. They are the largest network of independent primary care in the country, creating value-based contracts across various health plans.
Manage Medicare and Medicaid enrollment activities.
Oversee state-level entity enrollment for all jurisdictions.
Manage the vendor contract workflow.
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. They deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers; through their leading-edge care model they are shaping the future of community-based palliative care nationwide.
Own market operational performance against organizational and contractual outcomes, ensuring initiatives drive measurable clinical and financial results
Lead operation partnerships with customers in the market, aligning on market strategy, contractual goals, and performance targets across cost, quality, and member experience.
Partner with the clinical leadership to align care model execution with operational strategy, ensuring seamless member experience and optimized performance outcomes
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. Through our leading-edge care model, Tuesday Health is shaping the future of community-based palliative care nationwide.
Lead the design and execution of the Medicare Advantage Transformation plan.
Direct cross-functional workstreams to implement key MA initiatives.
Monitor key performance indicators for the MA business line.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
The Hospital Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system.
You will ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates and collaborate with senior team members to process new client implementations.
Independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries where their corporate headquarters are in Dublin, Ireland.
Assist with planning, directing, and implementing managed care objectives related to contract terms, reimbursement, negotiation, and key payer relationship management.
Negotiate various contract types across the organization's geographies and business lines with significant payer relationships.
Secure favorable reimbursement, protect the interests of associated entities in contract negotiations, and strengthen relationships with significant payers.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.
Assist in drafting, reviewing, and revising contracts to ensure accuracy and compliance.
Support negotiations by preparing documentation and analyzing proposed terms.
Maintain centralized systems for tracking contract status, renewals, and compliance requirements.
Teleios Collaborative Network (TCN) appears to be an organization focused on healthcare and committed to anti-racism, diversity, equity, and inclusion. They aim to foster a safe and transformational environment for staff and patients.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. They partner with over 450 companies and provide care for 10 million people.
Overseeing the creation, reviewing, and management of contracts to ensure compliance.
Executing and managing contracts to ensure terms are fulfilled as intended.
Analyzing contract language to confirm technical viability and alignment with business objectives.
Brightspeed provides fast, reliable internet connections and customer experience in twenty states throughout the Midwest and South. They are backed by funds managed by Apollo Global Management and aims to upgrade copper to fiber optic technologies by best-in-class customer experience.
Lead the Market Access Contracting team, providing development, direction, and oversight on a daily basis.
Review, approve, and sign Market Access Contracts; ensure department is SOX compliant and serve as contracting lead for periodic internal and external audits.
Lead the Pricing Governance Process for assigned Accounts and Segments, coordinating across the cross functional partners in Market Access, Legal, MMF, Finance, and Trade Ops.
Novartis focuses on the needs of people and a community committed to meeting them to improve the lives of people living with disease. It is a team working, learning and thriving together.
Manage Installation Documentation Requirements, review and ensure accuracy of required installation documents for all new sales orders; collaborate with all necessary stakeholders to obtain final approval of completeness
Oversee RMA Administration Process, Obtain and distribute Time & Material estimates to customers; handle all follow up communication with customers for authorization
Develop and Administer Contract Proposals, Work closely with internal and external stakeholders as needed to generate renewal contract quotations; maintain quotation database
FUJIFILM Healthcare Americas Corporation innovates for a healthier world with cutting-edge healthcare solutions spanning diagnostic imaging, enterprise imaging, endoscopic and surgical imaging, as well as in-vitro diagnostics. Fujifilm is globally headquartered in Tokyo with over 70,000 employees across four key business segments and guided by their Group Purpose of “giving our world more smiles.”
Review, draft, negotiate, and track legal agreements.
Work closely with the Clinical Operations study team.
Ensure deliverables align with defined study timelines.
Precision Medicine Group is a company that works in the pharmaceutical and healthcare industries. They are an equal opportunity employer that values diversity and inclusion.
Partner with Support and Optimization teams to ensure the best client experience.
Provide consultative guidance to clients throughout their life cycle, understanding Experian Health product capabilities.
Evaluate customer use of Contract Manager and Claim Scrubber products to recommend best practices.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries.
Develop and execute lifecycle marketing programs that support provider acquisition and engagement.
Design personalized messaging strategies tailored to different provider cohorts.
Analyze campaign performance and provider behavior data to identify engagement opportunities.
BetterHelp is on a mission to remove traditional barriers to therapy and make mental health care accessible. Founded in 2013, they are the world’s largest online therapy service with over 30,000 therapists helping millions globally.
Act as the product owner for procurement workflows and tooling.
Manage renewals and vendor lifecycle hygiene.
Cresta's platform combines AI and human intelligence to help contact centers discover customer insights and empower every team member. They are recognized by Forbes and Bain Consulting as one of the top private AI companies in the world.
Partner with cross functional leaders to ensure internal processes and care delivery are in accordance with health plan needs across commercial and Medicaid lines of business
Translate health plan contracts, provider manuals, and regulatory requirements into scalable operational workflows
Serve as the internal subject-matter expert on credentialing and payor operational requirements
Equip is a virtual, evidence-based eating disorder treatment program. They aim to provide accessible and effective treatment. Founded in 2019, Equip has been a fully virtual company and has a highly-engaged, passionate, and diverse culture.
Ensure contractual commitments are managed effectively while supporting strategic projects.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Oversee the entire renewals process, ensuring that customer contracts are renewed accurately and on time.
Collaborate with various teams such as Sales and Customer Success to drive revenue retention and customer satisfaction.
Enhance operational efficiency and compliance, directly impacting the partner's growth.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. The system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.