By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

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Provider Network Negotiation Specialist

PRIMARY PURPOSE: To negotiate fee-for-service ancillary contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Negotiates fee-for-service home health and home infusion therapy, and other ancillary services; contracts for multiple lines of business in the managed care markets.

• Analyzes market data and financial models.

• Prepares, negotiates, and administers provider contracts.

• Develops and expands provider participation within the network.

• Maintains provider participation within the network.

• Monitors provider performance; implements corrective action plans.

• Identifies current issues and probable future issues; guides staff through resolution.

• Documents contracts; updates contracts as changes occur.

• Coordinates customer inquiries.

ADDITIONAL FUNCTIONS and RESPONSBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred. 

Experience Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred. Two (2) years supervisory experience preferred.

Skills & Knowledge

• Strong project management skills

• Excellent negotiation skills

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• Analytical and interpretive skills

• Strong organizational skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations.

TAKING CARE OF YOU BY

•  We offer a diverse and comprehensive benefits package including:

  • Three Medical, and two dental plans to choose from.

  • Tuition reimbursement eligible.

  • 401K plan that matches 50% on every $ you put in up to the first 6% you save.

  • 4 weeks PTO your first full year.

NEXT STEPS

If your application is selected to advance to the next round, a recruiter will be in touch.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($70,000.00 - $75,000.00/year.. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.