Manager, Hospital Health Plan Provider Contracts (Florida)

Job description

JOB DESCRIPTION: *****Employee for this role must reside in Florida***** Job Summary: Leads and manages team responsible for Hospital Health Plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Responsible for negotiating complex contracts that are strategically critical to plan success, including but not limited to: alternative payment models (APMs), value-based payment (VBP) contracts and capitated payments for hospitals, independent physician associations (IPAs), and complex behavioral health arrangements. Essential Job Duties: - Oversees the plan’s Hospital provider contracting function; collaborates with other operational departments and functional business unit stakeholders on various provider contracting activities. - Negotiates contracts with the complex provider community that result in high quality, cost-effective and marketable providers. - Contracts/re-contracts with large-scale entities involving custom reimbursement. - Executes standardized alternative payment model (APM) or value-based payment (VBP) contracts. - Issues escalations and supports network adequ...