Ancillary Contracts Manager

Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com

 

JOB SUMMARY:

 

The Ancillary Manager negotiates contracts primarily with ancillary providers and vendors. Negotiates contracts with Hospitals and Provider Groups as needed. Develops strategy for ancillary provider network composition and formulates plan to address network gaps in sync with ancillary strategy. Researches and models payment methodologies, budgets Health Care costs, and evaluates and analyzes contract performance. Acts as the relationship manager for ancillary providers and vendors. Integrally involved in new product roll-out and provider communication. Acts as project lead for provider related special projects.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES: Negotiates Contracts, including analyzing data, modeling payment methodologies, negotiating reimbursement and contract language and relationship management. Performs strategy development and execution, including budgeting health care costs and analyzing contract performance data. Offers provider issue resolution and problem solving. Performs ad hoc and special projects.



REQUIREMENTS:

 

Education:

Bachelor’s degree.

 

Certification/License:

 

Experience:

Prior contract negotiation experience.

 

Knowledge, Skills & Abilities:Knowledge of Medical Terminology. Knowledge of contract language and payor reimbursement methodologies. General health care knowledge, including familiarity with standard coding, medical conditions, health care facility and provider group billing and operations, Medicare and State regulations relating to contract terms and limitations, prevailing provider market conditions. Familiarity with commercial and Medicare health insurance products. Strong data modeling and analytical skills. Microsoft Office Applications including Word, Excel and Access. Proven ability to negotiate critical provider contracts on schedule and within budget.

OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

 

As a government contractor, this position requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF85P or higher security.

 

Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.

 

Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.