Soma Capital Portfolio Jobs

Network Contracting Specialist



Posted on Thursday, November 9, 2023

Duties And Responsibilities

  • Manages contract negotiations with physician groups. Conducting several negotiations simultaneously to meet growth demands. 
  • Proactively builds relationships that nurture provider partnerships to support the local market strategy. 
  • Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, Claims, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing. 
  • Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position. 
  • Identify and manages initiatives that improve total medical cost and quality. 
  • Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. 
  • Assists in resolving elevated provider service complaints. Research problems and negotiates with internal/external partners/customers to resolve complex and/or escalated issues. 
  • Manages key provider relationships and is accountable for critical interface with providers and business staff. 
  • Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape. 
  • Partner with Regulatory Affairs to ensure all network filings are timely and accurate.
  • Performs other duties as assigned


Position Requirements

  • Bachelor’s degree or equivalent experience in related field, plus 5+ years of work experience beyond degree within provider contracting and/or health insurance 
  • Experience with Physician group contracting and negotiations 
  • Experience negotiating delegated credentialing agreements 
  • Experience in developing and managing key provider relationships including senior executives 
  • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners 
  • Intimate understanding and experience with larger, more complex integrated delivery systems managed care, and provider business models 
  • Team player with proven ability to develop strong working relationships within a fast-paced organization 
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations 
  • Customer centric and interpersonal skills are required  Superior problem solving, decision-making, negotiating skills, contract language and financial acumen
  • Remote with occasional travel (5%)
  • Existing relationships with physician groups in Texas and/or Florida will be helpful