The Hospital Contractor Executive is responsible for identifying, recruiting, negotiating and contracting providers to join the Prime Health Services PPO network with a focus on workers' compensation, commercial group health, auto liability, and personal injury with a focus on hospitals and health systems.
What You'll Do
Recruitment of Providers, ancillary facilities, hospitals and health systems via phone, email, or mail campaigns to negotiate PPO contracts for PHS Core business initiatives; ensuring contracts are cost effective and in compliance with all State, Federal, and corporate requirements
Negotiate payment rates and payment terms for new and existing contracts within PHS corporate requirements including terms and conditions associated with State or Federal guidelines
Successfully negotiates PPO contracts with large medical provider groups, independent hospitals, integrated care models, and health care systems
Analyzes data to develop strategies for contracting and re-contracting
Performs data analytics of proposed rates to ensure contracts for new and existing providers align with defined contracting guidelines
Meets/exceeds daily call metrics, completion of negotiated contracts as defined by contracting leadership, which is subject to review and modification
Manages and oversees assigned contracting tasks for specified geographic regions
Ensures contract proposals are complete and accurate prior to sending information to the Provider for review and/or signature
Establishes and maintains productive professional relationships with the Provider, hospitals, and health systems
Enters progress reports and any notations regarding contracting efforts into PHS proprietary database
Travel up to fifty percent (50%) may be required as needed to conduct stewardship meetings with Providers
Requirements
What We're Looking For
Bachelor's Degree in Communications/Business or related field of study from an accredited college or university, or equivalent experience required
8+ years of managed care contract experience preferred
Demonstrated negotiation skills and experience interfacing with C-Suite level contacts
Competencies
Must be able to successfully work in a collaborative, deadline driven work environment
Professional, friendly demeanor with excellent written and oral communication skills
Flexible, adaptable, creative, organized, and self-motivated
Must have strong negotiations and problem-solving skills and the ability to prioritize
Strong customer service, public relations, and technical skills required, including Microsoft Office
Why You'll Love Working at Prime Health Services
Medical Insurance (high deductible plan with an HSA)
Dental Insurance
Vision Insurance
Short-term and long-term disability paid by the company
Group term life paid by the company
Generous PTO policy
Employee recognition programs with monetary rewards
Corporate office amenities
Regular employee events
About Us
Prime Health Services (PHS) is a national medical cost containment company specializing in customized PPO network solutions. Since 2001, we've partnered with insurance carriers, TPAs, self-insured groups, and government entities to deliver high-quality healthcare access at discounted rates. Our technology-driven approach allows us to provide fast, flexible, and dependable service to our clients while supporting a collaborative, employee-focused workplace.
Numbers & Facts
Location
Franklin, TN
Skills
Campaignsunmatched
Communication Skillsunmatched
Contract Negotiationunmatched
Cost Controlunmatched
Customer Support/Serviceunmatched
Data Analysisunmatched
Establish Prioritiesunmatched
Health Insuranceunmatched
Healthcareunmatched
Healthcare Providersunmatched
Hospitalunmatched
Hospital Systemsunmatched
Leadershipunmatched
Managed Careunmatched
Metricsunmatched
Microsoft Officeunmatched
Negotiation Skillsunmatched
Organizational Skillsunmatched
Personal Injuryunmatched
Preferred Provider Organization (PPO)unmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Progress Reportsunmatched
Provider Contractingunmatched
Public/Media/Press/Analyst Relationsunmatched
Stewardshipunmatched
Strategic Planningunmatched
Team Playerunmatched
Time Managementunmatched
United States Public Health Serviceunmatched
Vision Planunmatched
Worker's Compensationunmatched
Writing Skillsunmatched
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