Provider Contracting Specialist

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth, improve outcomes, reduce costs, and bring value to their members.

Through our comprehensive suite of innovative supplemental benefits, fintech payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the social determinants of health and improve member health outcomes and satisfaction.

Our compliance-focused infrastructure, proprietary technology systems, and premier service delivery model allow our health plan partners to deliver high-quality, value-based care to millions of members.

We offer a fulfilling work environment that attracts top talent and encourages all associates to contribute to delivering premier service to internal and external customers alike. Our goal is to transform the healthcare industry for the better! We provide career advancement opportunities from within the organization across multiple locations in the US, South America, and India.

Provider Contracting Specialist

Position Summary

The Provider Contracting Specialist serves as the primary contracting and negotiation resource for provider network expansion efforts across dental, vision, and hearing specialties. Working in close partnership with Provider Recruiters, this role is responsible for converting engaged provider prospects into contracted network participants through effective negotiation, relationship management, and consultative problem-solving.

While Provider Recruiters focus on high-volume outreach, opportunity generation, and stakeholder identification, the Healthcare Contracting Specialist acts as the "closer" for complex contracting opportunities. This individual leads reimbursement discussions, addresses objections, navigates counterproposals, and guides providers through the contracting process from engagement to executed agreement and enrollment.

The ideal candidate combines healthcare industry knowledge, strong negotiation skills, provider relations experience, and the ability to build trust with practice owners, administrators, and healthcare leaders.

Key Responsibilities

Contract Negotiation & Execution

• Lead contract negotiations with prospective dental, vision, and hearing providers and practices.
• Review and negotiate reimbursement arrangements, contract terms, and participation requirements.
• Evaluate provider counterproposals and develop recommendations that align with network strategy and business objectives.
• Address provider concerns related to reimbursement, network participation, claims processes, credentialing, and operational requirements.
• Facilitate timely execution of provider agreements and ensure all required documentation is completed accurately.

Provider Relations & Consultative Support

• Serve as the primary point of contact for engaged providers requiring high-touch, consultative support.
• Build strong relationships with practice owners, office managers, administrators, and other key stakeholders.
• Present the value proposition of network participation and effectively communicate benefits to providers.
• Resolve objections and barriers to participation through strategic problem-solving and relationship management.
• Maintain a positive provider experience throughout the contracting and onboarding process.

Partnership with Provider Recruitment Team

• Collaborate closely with Provider Recruiters to create a seamless provider acquisition process.
• Accept warm leads and scheduled opportunities generated by recruiters and advance them through the contracting cycle.
• Participate in provider meetings and consultations to support complex negotiations.
• Provide feedback to recruiters regarding market conditions, provider concerns, competitive insights, and contracting trends.
• Support network growth initiatives by helping maximize provider conversion rates.

Network Development & Enrollment

• Coordinate provider enrollment activities following contract execution.
• Ensure providers meet network participation requirements and onboarding milestones.
• Track contracting progress and maintain accurate records within CRM and contracting systems.
• Support achievement of provider recruitment, contracting, and network adequacy goals.
• Identify opportunities to improve contracting processes, provider experience, and operational efficiency.

Qualifications

Required

• Bachelor's degree in Healthcare Administration, Business, Public Health, or related field, or equivalent experience.
• 3+ years of experience in healthcare contracting, provider relations, provider recruitment, network development, or a related healthcare role.
• Experience negotiating contracts, rates, or business agreements.
• Strong communication, presentation, and relationship-building skills.
• Demonstrated ability to manage multiple priorities in a fast-paced, goal-driven environment.

Preferred

• Experience working with dental, vision, hearing, medical, or ancillary provider networks.
• Knowledge of provider reimbursement methodologies and healthcare contracting principles.
• Experience supporting credentialing, provider enrollment, or network operations.
• Familiarity with managed care or healthcare network development.
• Experience working directly with healthcare practice owners and administrators.

NationsBenefits is an Equal Opportunity Employer.