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About the Role

BHPS is seeking a Contract Manager responsible for the contracting and maintenance of relationships with network health systems. This role involves recruiting and managing the provider network, including hospitals and physician groups in the New York metro market. The successful candidate will perform due diligence to secure new contracts and re-contract with existing providers for cost-effective arrangements. This position requires a strategic and operationally oriented professional with strong communication skills and the ability to build partnerships, manage projects, and drive network development.

Responsibilities

Review, analyze, negotiate, implement, and maintain existing contracts, understanding professional rate schedules and contractual language.
Identify network development opportunities through financial analysis, client requests, and product development.
Define performance improvement opportunities.
Implement new and evolving strategic contract initiatives, including alternative payment methodologies like bundling, value-based payment, and pay for performance.
Analyze reports on cost, utilization, claim submission patterns, and outcomes, and prepare presentations on findings.
Develop, implement, and support efforts to build new network solutions and deploy them as appropriate.
Assist in resolving provider issues, including root cause analyses, mediation, and assessing strategic relevance.
Partner with different areas for outstanding payments, medical management, and provider policy.
Perform other duties and projects as assigned by supervisor.

Requirements

Minimum 5 years in a provider or hospital administration role.
Strong understanding of contract language.
Strong understanding of professional provider cost structures and reimbursement methodologies.
Sound knowledge of healthcare contracting.
Demonstrated analytical and negotiation abilities.
Excellent communication and presentation skills.
Ability to multi-task.
Organized and methodical.
Customer service skills.
Proficiency in Excel.

Skills

Contract negotiation
Provider network management
Financial analysis
Strategic planning
Project management
Provider outreach
Analytical skills
Communication skills
Presentation skills
Excel proficiency
SQL
Access
Revenue cycle management

Location

Long Island

Work Type

Hybrid

Experience Level

Minimum 5 years

Education Level

Master's Degree

About the Company

Brighton Health Plan Solutions, LLC is committed to improving healthcare access and delivery.
The company fosters a diverse, inclusive, and welcoming culture.
BHPS partners with self-insured employers, Taft-Hartley Trusts, health systems, providers, and TPAs.
They offer flexible and cutting-edge third-party administration services.
BHPS leverages decades of health plan management expertise, proprietary provider networks, and an innovative technology platform.
As a healthcare enablement company, they provide customizable tools to enhance member experience, improve health outcomes, and achieve client goals.
Company Mission: Transform the health plan experience by bringing outstanding products and services to partners.
Company Vision: Redefine health care quality and value by aligning partner incentives.