Pacific Medical Centers Supervisor, Network Contracting & Provider Relations in Seattle, Washington
Find what you’re looking for in your career, at PacMed as a Supervisor Network Contracting & Provider Relations in Seattle, WA.
This is a full time position and is eligible for benefits.
We are seeking a Supervisor Network Contracting & Provider Relations to be responsible for leading contract negotiations for acceptable reimbursement terms and contract language with all network providers across the continuum of care.
In this position you will:
Be responsible for the continued development and implementation of the Network Management Plan.per URAC and DoD guidelines.
Be responsible for the development and maintenance of the Network Plan, the Provider Handbook as well as the evaluation of the adequacy of the network and for assuring that the network meets URAC and DoD standards.
Be responsible for assuring providers and network members are educated in Health Plan criteria and processes and acts as the primary resource for orientation and coaching for performance improvement.
Be responsible for compliance with the DoD contract regarding network and utilization issues and assists contract providers in understanding contractual obligations.
Be responsible for a key role in provider contracting and network relations.
Act as a representative and spokesperson for US Family Health Plan both internally and externally.
Required qualifications for this position include:
Bachelor’s degree in a related field.
Minimum of 5 years of experience in managed care operations.
Extensive experience and understanding of capitated medicine, contracted networks and health plan contracts.
Extensive knowledge of information systems and enterprise level software.
Preferred qualifications for this position include:
Experience working in ambulatory medicine.
Pacific Medical Center :
Pacific Medical Center is an expanding network of outpatient clinics providing primary and specialty care to the greater Seattle area and employing more than 150 providers representing most medical specialties. Pacific Medical Centers is affiliated with Providence Health & Services, which operates 28 exceptional not-for-profit hospitals and more than 350 clinics across the West. With hundreds of physician and advanced practice provider opportunities in virtually all specialties at any given time, Pacific Medical Centers and Providence offer diverse locations, lifestyles and practice models. Find what you are looking for in your next practice opportunity with Pacific Medical Centers! Learn more at www.pacmed.org/providerjobs .
We offer a full comprehensive range of benefits — see our website for details —
Our mission is to provide respectful, high-quality, patient-focused healthcare to each person and to the communities we serve.
Quality and respect. These are the words Pacific Medical Centers (PacMed) employees live and work by. PacMed is a private, not-for-profit, primary and integrated multispecialty health care network with 10 outpatient clinics across the Puget Sound region and more than 175 primary and specialty care providers. Affiliated with the Providence Health & Services system, PacMed provides patient-focused health care — and even same-day appointments — to patients in King, Snohomish and Pierce counties. We provide immediate access to cutting-edge technology, first-class facilities and board-certified specialists, many of whom have been listed as among “Seattle’s Best Doctors.”
Pacific Medical Centers, PacMed, and their Affiliates' (collectively “PacMed”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. PacMed does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Job Category: Non-Clinical Lead/Supervisor/Manager
Req ID: 207747