Client Relationship Manager
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Position Overview
Job Description
Duration: 12 Months Contract – To – Hire
Location: Harrisburg / Pittsburgh PA
Job Description:
• Responsible for development and management of provider networks for all products: Medicaid, and Medicare.
• Responsible for hospital and physician network development and management.
• Develops and recommends policy changes related to provider recruitment and contracting.
• Recruits and negotiates contracts with specific providers within operational and potential new counties to meet company requirements.
• Oversees training and communication for network providers and acts as a liaison with the provider community.
• Ensures compliance with pricing guidelines established by AMFC and Plan.
• Ensures provider contracting is consistent with claim payment methodologies.
• Maintains familiarity with Medicare and State Medicaid fee schedules and reimbursement methodologies and analyzes comparable Plan pricing guidelines.
• Resolves difficult complex contract issues to ensure that provider contracts are in compliance with state, federal, national accrediting agencies and Plan contracting guidelines.
• Ensures that non-standard contract elements are communicated to appropriate departments and obtains AMFC and Plan approval prior to submission to provider.
• Responsible for the accuracy and timely management of all provider contracts.
• Responsible for implementation of electronic strategies for provider network to include increasing electronic claims submission and implementation of improved processes that result in increased auto-adjudication of claims.
• Responsible for achievement of quality and health plan objectives through accomplishment of provider initiatives
• Bachelor’s degree in business or health related discipline such as Healthcare Administration or Healthcare Management or equivalent business experience required
• Master’s Degree highly preferred.
• Minimum of 5 years provider contracting/reimbursement experience in healthcare setting required
• 1-2 years Medicaid experience required
Best Regards,
NIRMAL CHATTERJEE
Technical Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I
Direct Line # : 732-429-1911
BOARD # : 732-549-2030 – Ext - 306
www.irionline.com
LinkedIn: https://www.linkedin.com/in/nirmalyachatterjee
Gold Seal JCAHO Certified ™ for Health Care Staffing
Practice Area
Position
Senior
Application Deadline
September 7, 2026
Employment Type
Contractor
