Sr. Network Contractor
Current- Contract negotiations for the development of network and member health benefits under Cardiac Monitoring, DME, Dialysis, Orthotics and Prosthetics, Vision Services, and PT/INR Monitoring portfolios for 145+ providers.
- Ensure the development, implementation, cohesion, and organization of SelectHealth contracts and amendments over multiple years of legal jargon and claims rates.
- Coordinates across multiple departments working with a variety of staff to confirm the accuracy of provider contracting information within SelectHealth software applications.
- Regularly meets with legal team, actuaries, and upper management to plead the case for adding additional providers at pre-negotiated rates to fill gaps of services for SelectHealth members.
- Used ability to problem solve and Lean experience by creating contracting request form in order to eliminate time spent gathering provider business and services information, making it easier to run providers through a.
- Greater than 8 years of reviewing contracts and legal language over pharmaceutical and health insurance career.
Aug 2020 - Present
