Senior Administrator, Provider Network
Core
Develop and manage a high-performing, cost-effective, and compliant provider network for a managed care organization.
Role type
Senior Provider Network Administrator
Builds
Provider networks (PCP, specialists, ancillary, hospitals) aligned with regulatory standards and organizational objectives
Domain
Healthcare / Managed Care
Required skills
Provider contracting, contract interpretation, negotiation, client relations, contract lifecycle management, provider database management, reimbursement methodologies (fee-for-service, capitation, value-based), healthcare regulatory compliance (CMS, DHCS, DMHC, NCQA)
Preferred skills
Managed care experience, physician group experience, clinical-based organization experience, hospital/facility setting experience
Responsibilities
Negotiating and executing provider contracts, maintaining relationships with providers and clients, leading initiatives to expand the provider network, mentoring junior staff, securing new partnerships
Seniority
Senior, hands-on IC
