Job Description: Provider Management Specialist - Various Locations

Job Title: Provider Management Specialist

Department: Provider Management

Location: MP, Rajasthan, Orissa, West Bengal, North East, UP, Bihar, Jharkhand, Punjab, Chhattisgarh, and 4 positions in Gujarat covering Baroda, Ahmedabad, Vapi & Anand.

Reports to: Provider Management Team Lead

Employment Type: Contractual

Compensation: ₹15,000 - ₹20,000 per month, depending on experience

Job Summary:

The Provider Management Specialist will be responsible for the empanelment of healthcare providers, specifically hospitals, and for conducting negotiations to establish favorable contracts and partnerships. This role is crucial for ensuring that the organization has a robust network of providers capable of delivering high-quality services to our clients.

Key Responsibilities:

Empanelment of Providers:

• Identify and evaluate potential hospital partners for inclusion in the provider network.
• Manage the onboarding process for new hospitals, ensuring all necessary documentation and qualifications are met.

Contract Negotiation:

• Engage in contract negotiations with hospital administrators to establish mutually beneficial agreements.
• Analyze contract terms and conditions to ensure compliance with organizational guidelines and regulatory requirements.

Provider Relations:

• Serve as the primary point of contact for hospital partners, addressing any inquiries or concerns regarding contracts and network participation.
• Foster effective communication and relationships with providers to enhance collaboration and trust.

Data Management and Reporting:

• Maintain accurate and up-to-date records of all provider contracts and negotiations.
• Prepare reports and presentations for management on provider performance and contract outcomes.

Market Research:

• Conduct research to understand market trends and the competitive landscape affecting provider networks.
• Identify opportunities for expanding the provider network to meet organizational goals and client needs.

Cross-Functional Collaboration:

• Work closely with internal teams, including Sales, Compliance, and Quality Assurance, to ensure alignment on provider management strategies.
• Collaborate with other departments to enhance the overall service offerings and provider engagement.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field; medical professionals (MBBS, BAMS, BHMS) are also encouraged to apply.
• Minimum of 2 years of experience in provider network management, healthcare contracting, or related areas.
• Strong negotiation skills with a proven track record of successful contract outcomes.
• Excellent interpersonal and communication skills, with the ability to build relationships with diverse stakeholders.
• Proficient in data analysis and reporting, with strong attention to detail.
• Knowledge of healthcare regulations and compliance standards is preferred.

Preferred Skills:

• Experience working with hospital systems and an understanding of healthcare delivery models.
• Familiarity with electronic health records (EHR) systems and provider management software.
• Ability to work independently and as part of a team in a fast-paced environment.

This role is critical for developing and maintaining a high-quality provider network, ensuring that our clients receive the best possible care through well-negotiated and strategically managed partnerships.