Excellus Health Plan Inc.
Rochester, NY, USA
Job Description: Summary: As a professional within the network contracting and administration team, the incumbent will contribute to the development and maintenance of provider networks. This position is accountable for performing provider and network analysis, evaluating provider reimbursement, and negotiating provider contracts in accordance with corporate strategy. As such, the role requires a multifaceted understanding of provider types, applicable legal and regulatory requirements, pricing methodologies, industry and regional provider impacts & trends, provider reimbursement and related programs, and product lines. Essential Accountabilities: • Establishes and maintains network adequacy for assigned provider types, regions and/or lines of business. Serves as provider network contracting and administration subject matter expert for assigned areas. • Analyzes, develops, and proposes formal provider reimbursement recommendations within approved budgets and...