Employer: One Call
Responsible for working as liaison between Providers and organization. Identify, select, and monitor providers and draft and negotiate final contracts. Ensures optimal language is inserted into each agreement that will protect One Call, its patients and customers May create processes and procedures to ensure overall quality of provider services. Facilitate development of relationships with providers, maintain relationships for long-term contracts, and mediate performance and scorecard disputes.
GENERAL DUTIES & RESPONSIBILITIES:
- Draw up short term and long term Contracting Strategy for the development and improvement of One Call’s provider network
- Works independently and as part of a team on contract negotiations, renegotiations, contract preparation, provider relations and recruitment
- Reduce cost of goods sold through contract negotiations and renegotiations of existing vendor contracts
- Ensure quality components of service delivery and patient/carrier satisfaction with services provided
- Initially establishes relationships with providers and prepares handoff to account management team
- Participate in process for continuous credentialing and quality monitoring of assigned accounts
- Monitors state fee schedules by working closely with One Call’s Government Affairs Department to ensure vendor compliance
- Works with team to identify margin opportunities by performing analysis on out of network utilization and using data to identify network development opportunities
- Performs ad-hoc negotiations with out of network vendors and strategically recruits new vendors based on feedback from Operations and Sales
- Works closely with Internal Audit and Compliance (IAC) department to ensure vendor compliance with contracts as well as One Call’s billing and other protocols
- Identifies potential vendors for recruitment into the One Call network
- Identifies white space and targets vendors in those areas for inclusion in the One Call network
- Negotiates all new and existing contracts
- Performs contract and cost analysis
- Manages contract process including distributing and receiving contracts
- Acquires credentialing applications at initial contracting
- Acquires liability and licensure on each provider at initial contracting
EDUCATIONAL REQUIREMENTS:
- Bachelor’s degree or the equivalent combination of education, training, or work experience.
GENERAL KNOWLEDGE, SKILLS & ABILITIES:
- Good understanding of One Call products and services
- General knowledge of the workers’ compensation industry
- Requires expert negotiation and communication skills, both written and verbal
- Knowledge of Provider Relations
- Excellent verbal and written communication skills to technical and non-technical audiences of various s levels in the organization (e.g. executive, management, individual contributors)
- Excellent problem solving, team and time management skills managing multiple deadlines for self and others
- Proficiency in making projections of future expenses based on analysis of cost effectiveness of past expenditures
- Proficiency to operate independently on work that is often confidential in nature
Contract Negotiator
Has good understanding of contract negotiation principles as well as some legal acumen around common contract provisions. Generally is responsible for multiple Providers for contract drafting and negotiation of medium to moderately high complexity that require demonstrated knowledge. Educate and advise internal clients on issues relating to new contracts as well as analysis and interpretation of existing contracts for future use. Ensures contractual agreements are met. Develop alternatives, strategies and plans of action to facilitate the negotiation process. Works under moderately minimal supervision on moderately strategic, complex projects. Moderate latitude for independent judgment. Typically requires two to five (2-5) or more years of demonstrated related experience.