Contract Negotiator Job at AvMed Health Plans
Embrace better opportunities.
Are you passionate about health, happiness and helping others? So are we. We’re committed to helping our health plan Members live a happy and healthy lifestyle, and we believe that it starts here first, with our Associates.
At AvMed, we provide the tools and opportunities to enhance, expand, and support each Associate’s personal and professional growth. From tuition reimbursement to exercise classes in the office, embrace a better career with AvMed and join our team!
Position: Contract Negotiator
Scope of position: The Contract Negotiator has overall responsibility and accountability for the successful negotiation and contracting of physicians, facilities, and ancillary providers.
Essential Job Functions:
- Negotiate, contract, service and retain a competitive provider network in assigned geographic territories. Negotiations to include both contractual rate and language provisions that adhere to established departmental guidelines.
- Service the applicable Physician network to ensure an optimal experience for our providers
- Ensure that there are the appropriate number and location of physician specialties to meet referral needs, accessibility standards and marketing needs.
- Coordinates with Provider Data Contract Management and other pertinent departments to ensure all contractual language is configured correctly for accurate claims adjudication; and ensures pre-testing for selected, more complex Physician agreements.
- Performs additional duties and responsibilities as assigned by management
We Offer:
- Competitive Salaries
- Comprehensive Benefits: Medical Plans, Health Savings Account, Dental, Vision, and more…
- Paid Time Off, Company Paid Holidays, Paid Time Off Cash-In
- 401(k)plan with matching contributions, Tuition Assistance, Associate Discounts
You have:
- Associates degree required
- Bachelor’s Business Administration or Healthcare related field preferred
- 3-5 years of experience with either payer or provider contracting and building/recruiting provider network(s)
- Experience with the servicing of provider contracts including but not limited to, loading of contracts, and working with our Provider Network Operations team to resolve claims issues
You May Also Have:
- Minimum of three years of healthcare contract negotiation experience, with direct contact with physicians/facilities and office staff
- Knowledge of the South Florida marketplace, its provider networks, and managed care dynamics
- Strong knowledge of & skills in Excel & Word
- Familiar with varying payment methodologies ie Fee for Service, capitation, Medicare fee schedule
Environment:
At AvMed, you will find a family. Our Associates love all the opportunities for advancement, the flexible work environment and team activities. We also encourage our Associates to embrace a life rich in what matters most — health and happiness. We call it being WELLfluent. Join AvMed. Join the WELLfluent!
Location: 100% Remote. Requires travelling within Miami Dade, Broward and Palm Beach Counties in Florida.
AvMed is a tobacco/drug free workplace, EOE
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