About the role
Serves as the primary liaison between providers, clinical leaders, operational teams, and the contracting department. Ensures provider understanding of payer contracts, payment methodologies, operational requirements, and value-based performance expectations.
Reports To: Payer Contracting, Policy & Regulatory Counsel
Key Responsibilities
Provider Engagement
- Build relationships with providers.
- Educate providers regarding contractual requirements and reimbursement methodologies.
Contract Performance Support
- Assist providers with contract-related issues.
- Coordinate escalation of payer operational concerns.
Operational Collaboration
- Partner with revenue cycle and finance.
- Support implementation of contract changes affecting providers.
- Facilitate provider feedback into contracting strategy.
Education & Communication
- Develop provider-facing educational materials.
- Lead presentations regarding contracting policy, disputes/resolutions.
- Ensure awareness of payer policy changes.
Qualifications
- Bachelor's degree required.
- 5+ years healthcare operations, contracting, provider relations, or managed care experience.
- Strong facilitation and relationship management skills.
- Excellent communication and presentation abilities.
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