Sr Network Development Executive

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. In addition, this position is responsible for working with management in the aggressive execution of regional strategies based on market trends and client expectations as well as continuous evaluation of assigned territory penetration and discounts. This role may support other areas such as MultiPlan's Payment Integrity and Analytics-Based Services.

JOB ROLES AND RESPONSIBILITIES:

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 tends and client expectations through comprehensive, aggressive execution of region-specific contracting goals derived from national and regional objectives related to penetrations and discount objectives, and improved contractual terms.
3. Foster and maintain superior provider relationships, including management of the business relationship with large, complex providers. Respond to provider questions, issues, and problems that have been appropriately escalated and produce a solution. May managed relationships with leased networks.
4. Conduct complex internal audits and reviews of existing provider relationships and supporting documentation to resolve internal or external inquiries.
5. Function as provider-specific expert by identifying, understanding, and documenting strategic business needs and market strategies. Maintain, and preferably exceed, contracting production and quality standards consistent with established regional goals.
6. Prepare analyses, reports and presentations by collecting, analyzing, and summarizing information and trends.
7. 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 marketability of commercial and government products.
8. 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.
9. Work with Sales and Account Management to respond to and anticipate access requirements and network related performance guarantees.
10. Partner with HCE to conduct financial analyses and monitoring of marker trends to identify, develop, and implement competitive reimbursement.
11. Monitor, compare and contrast market competitive information to develop and initiate growth strategies by developing action plans to assess network adequacy and regional competitiveness.
12. Please note, due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
13. Comply with mandatory training programs requirements, including Human Resources, product orientation and contracting tools and resources.
14. Ensure compliance with established policies and procedures and with regulatory 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.

JOB SCOPE:
Incumbent is considered to be a senior staff professional who knows and applies a comprehensive knowledge of principles, practices, and procedures related to the completion of complex or difficult negotiation and maintenance of provider network contracts. An incumbent works independently and has substantial latitude for unreviewed action or discretion and may have authorization to act outside standardized procedures, and provides assistance to less experienced Provider Contractor jobs in resolution of complex issues. An incumbent may act in a liaison capacity with other departments and may be called upon to evaluate progress and results as well as to recommend major changes in procedures. This job does not directly manage others but may be called on to provide project or work direction to less experienced Provider Contractors. The job may require overnight travel to meet with providers in assigned geographical or areas of responsibility and/or travel to company sponsored meetings and events. The incumbent will possess the skills necessary to strategize construct and negotiate complex financial rate structures and contract language, and can demonstrate successful negotiations that require this skill set.