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Imagine360 is currently seeking a Sr. Contract Specialist to join our team! This position is responsible for physician provider contracting, day-to-day support of the provider networks as assigned and for performing ongoing network analysis for all contracts pertaining to network development needs. The primary function is recruiting and contracting with physicians who meet established selection criteria. This crucial role directly impacts the experience of the members, providers and payers that use our core product. Reporting to the Senior Manager of Contracting, this role requires an entrepreneurial approach to negotiating physician contracts to help the growth and success of new networks in targeted markets.

Position Location: 100% remote

Responsibilities include but are not limited to:

• Assess, recruit and organize provider contract needs for PPO networks and other critical provider partnerships
• Negotiate complex contracts with physician and other healthcare provider contacts
• Assist with legal review and interpretation with regard to the financial and legal impact of provider contract language as requested
• Conduct rate and contract negotiations with all assigned contracting entities in collaboration with company leaders
• Work in partnership with corporate leaders ensuring contracting and other collateral information meets the needs of contracting elements
• Assist with market analysis for development projects
• Support new start activity and identify other potential business opportunities to support core growth
• Work closely with the operations and customer success teams to ensure our clients and TPA partners are adhering to our provider contracts and policies
• Attend provider meetings and team meetings either locally or with occasional travel, as needed

Required Experience / Education:

• High School Diploma or GED
• Bachelor's Degree preferred
• 2+ years as a provider or payer representative in the managed care, benefits, or health insurance industry
• 2+ years recruiting new providers into a new or established network (preferred)

Skills and Abilities:

• Substantive knowledge of managed care industry including compliance
• Must be familiar with healthcare pricing and reimbursement technologies, including solid knowledge of ICD-10, MSDRG and CPT Codes
• Strong written, verbal and presentation communication skills and effective relationship management experience a must
• Attention to detail; ability to juggle multiple priorities and deadlines; strong follow through
• Must be comfortable with making several cold calls to physician groups daily
• Ability to work independently as well as collaborate within a team environment
• Must possess strong analytical and problem-solving skills
• Proficient in the MS Office Suite to include MS Word, Excel, PowerPoint, Outlook and Teams

What can Imagine360 offer you?

• Multiple Health Plan Options
• Company paid employee premiums for disability, and Life Insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation