Provider Relation Negotiator

Job Title: Provider Agreements Negotiator

Date: 9/30/23

Department: Provider Relations

Weekly Hours: 40

Reports to: Provider Relations Manager

FLSA Status: Non-Exempt

POSITION OVERVIEW:
The Provider Agreements Negotiator will negotiate the best possible agreements for Solidarity and its Members. When an interested provider is identified, the Provider Agreements Negotiator will initiate Direct Agreement conversations with the intent of fortifying that relationship into a Direct Agreement. These negotiations will range from hospitals to independent facilities.

PRIMARY DUTIES AND RESPONSIBILITIES: (ESSENTIAL FUNCTIONS)
Uphold and integrate Solidarity's Catholic and Christian identity and foster the teachings of the
Church in all aspects of your job responsibilities;
Understand Solidarity's mission and demonstrate Solidarity's values while communicating with both Members and providers;
Initiate, lead, and manage negotiations with healthcare providers, hospitals, clinics, physicians, and other healthcare facilities;
Analyze and negotiate pricing, reimbursement rates, and service fees to achieve the most favorable terms for Solidarity and our Members;
Address and resolve issues, concerns, and disputes that may arise during negotiations;
Achieve performance targets related to negotiations, Preferred Provider growth, and other key performance indicators (KPIs);
Initially establishes relationships with providers and prepares a hand-off to the Account Management Team once a Direct Agreement is established;
Work directly with Member Care, Care Coordination and other departments as they relate to the provider experience.

SECONDARY DUTIES AND RESPONSIBILITIES:
Collaborate with others and cross- departmentally to improve the Member experience;
Identify opportunities to update or improve company policy/procedure and make recommendations to the appropriate staff;
Assist the Provider Relations team with supporting the day-to-day functions of the department;
Perform other related duties as assigned.

REQUIRED QUALIFICATIONS & SKILLS:
Excellent verbal and written communication skills;
Expert negotiation/influencing skills with demonstrated ability to influence negotiated outcomes.
Ability to work as a member on a high- performance team while maintaining a positive work environment;
Strong analytical skills and ability to interpret complex financial and healthcare data;
Organized with attention to detail;
Must be able to travel as needed;
Ability to work independently, handle multiple projects simultaneously, and meet deadlines effectively;
Must be able to provide proof of eligibility to legally work in the United States;
Proficient in Microsoft Office Suite and related software.

EDUCATION AND EXPERIENCE:
Bachelor's degree in Business, Healthcare Administration, or a related field;
Proven experience in negotiating within the healthcare industry;
Experience interacting with Health Care Facilities preferred.

PHYSICAL REQUIREMENTS:
Prolonged periods sitting at a desk and working on a computer.
Must be able to lift 25 lbs.

WORKING ENVIRONMENT:
Professional office setting.