How to Become a Provider Contracting Manager
Step 1: Understand the job description and responsibilities of a Provider Contracting Manager
What does a Provider Contracting Manager do?
A Provider Contracting Manager manages contracting activities for a healthcare provider network. Oversees and monitors a contracts database system for a healthcare provider network to track, monitor, and record contract data. Being a Provider Contracting Manager assists in negotiating with facilities joining the health network and setting rates. Implements reporting standards to ensure consistent recording of contract data and ensure compliance with regulatory requirements. Additionally, Provider Contracting Manager analyzes various rate scenarios to forecast and evaluate rate setting strategies and identify trends. Requires a bachelor's degree. Typically reports to a director. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes.
A key emphasis of the role will be to ensure high performance work practices, governance, effective performance management principles and KPI’s for the governance of Bupa’s provider network and clinical management.
The role will be responsible for the implementation and management of processes and tools to ensure contractual compliance between Bupa Global and all its providers are being adhered to.
The role will be the central point of expertise and knowledge for Bupa’s relationship with its providers and will assist in the decision making of working with new and existing providers, local partners and case management.
The Provider Contracting Manager is accountable for the operational management and development of the Health & Benefits Team and will ensure the team maintain strong relationships with all providers within the Bupa Global network to ensure Bupa Global’s customer and partner propositions are managed to a high standard.
Based in Hong Kong, the Provider Contracting Manager is a key part of the Health & Benefits leadership team and is responsible for ensuring high performance work practices, governance, effective performance management principles and KPI’s for Bupa Global’s provider network and clinical management.
Step 2: Learn best tips to become a Provider Contracting Manager
Best tips for those who want to become a Provider Contracting Manager
Here are some tips to become a Provider Contracting Manager.
Tufts Health Plan will email a contract to the provider.
Tufts Health Plan will complete the credentialing process and notify the provider of their effective date.
Complete the CAQH credentialing application.
Complete the Ancillary Practitioner Data Form.
Complete the required credentialing/contracting documents.
Step 3: View best colleges and universities for Provider Contracting Manager
Best colleges and universities for Provider Contracting Manager
- Butler University
- Carroll College
- Cooper Union
- High Point University
- Princeton University
- Providence College
Step 4: Think about whether is it worth to be a Provider Contracting Manager
Is being a Provider Contracting Manager Worth it?
Work with internal departments and staff to negotiate Letter of Agreements with non contracted providers.
Track and trend data and identify potential contracting or service improvement opportunities.
Work with the Director of Contracting to ensure that contracting efforts are strategic in nature and results in an effective and high-quality network.
Manage IPA/Medical Group and Hospital contracting efforts through the entire procurement process, ensuring that contracts are administered, implemented and recorded accurately.
Director of Network Management/Provider RelationsDirector of Network Management/Provider RelationsRegal Medical GroupSan Bernardino, CA2 weeks ago.
Step 5: Prepare relevant skills for being a Provider Contracting Manager
What skills do you need to be a Provider Contracting Manager?
In order to drive yourself and your team to success, in a management position you need to have a broad base of skills. For success in this position, you effeciency with these skills is key: Contracts Management & Administration, Provider Management. For this role, you will need to be adept in with: Contract Management Software. Although every company varies in their requirements, these competencies will help you in this role.
Acts as the expert for the providers with regards to the agreements, fees and pricing in the region for which you are responsible.
Responsible for contracting select hospitals, employed physicians, and ancillaries required for CMS adequacy in expansion markets for the senior segment.
Build and maintain strong relationship with the provider community and matrix partners.
Understanding of the contractual templates and parameters and applying at the appropriate time with the appropriate provider.
5+ years of contracting experience within healthcare.
Step 6: View average salary for Provider Contracting Manager
How much does a Provider Contracting Manager make?
The average salary range for a Provider Contracting Manager is from $112,809 to $141,666. The salary will change depending on your location, job level, experience, education, and skills.
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Average salary for Provider Contracting Manager jobs
Step 7: Find relevant Provider Contracting Manager jobs, and apply.
Looking for Provider Contracting Manager jobs?
Here are some Provider Contracting Manager jobs in the United States.