Provider Contracting Rep

JOB SUMMARY
This position is responsible for identifying and evaluating opportunities in support of MultiPlan's Network-Based Solutions by negotiating optimal reimbursement rates, and drafting contracts for Network and non-network providers to support MultiPlan's commercial and government products. This activity will ensure patient access to the highest quality, cost-effective providers of healthcare services in accordance with applicable regulations and the Company's policies, practices and procedures. This role may support other areas such as MultiPlan's Payment Integrity and Analytics-Based Services.

1. Assist management in the identification and development of contracting priorities for assigned territory to support Network Development provider contracting initiatives.
2. Negotiate provider contracts to support penetration and discount objectives relative to competitive market trends and client expectations through comprehensive, aggressive execution of region specific contracting goals derived from national and regional objectives related to penetration and discount objectives, and improved contractual terms.
3. Foster and maintain superior provider relationships including management of the business relationship with assigned providers. Respond to provider questions, issues, and problems that have been appropriately escalated and produce a solution.
4. May assist in managing relationships with leased networks. May also assist in managing client/payor relationships through various commercial and government initiatives.
5. Maintain, and preferably exceed, contracting production and quality standards consistent with established national and regional goals.
6. Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends.
7. Partner with HCE to conduct financial analyses and monitoring of market trends to identify, develop, and implement competitive reimbursement.
8. Monitor, compare and contrast market competitive information to develop and initiate growth strategies by assisting in development of action plans to assess network adequacy and regional competitiveness.
9. Please note, due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.

10. May serve as mentor to less experienced Provider Contractors through on-going instruction, coaching, modeling, and counseling aimed at developing the type of skills and behaviors that will result in successful resolution of provider contracting. Share provider contracting insights and information with less experienced contractors.
11. Work with Sales and Account Management to respond to and anticipate access requirements and network related performance guarantees.
12. Comply with mandatory training programs requirements, including Human Resources, product orientation and contracting tools and resources.
13. Ensure compliance with established policies and procedures, regulatory requirements, and mandatory training requirements (such as but not limited to HIPAA, integrity, product orientation, and contracting tools/resources).
14. Collaborate, coordinate, and communicate across disciplines and departments. Develop and maintain positive relationships at all levels within the organization and identify and communicate provider needs to the applicable process owners
15. Demonstrate Company's Core Competencies and values held within.
16. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.