Client Relationship Manager

Artech is an employer-of-choice for over 5,800 consultants across the globe. We recruit top-notch talent for over 65 Fortune and Government clients coast-to-coast across the U.S., India, and China. We are one of the fastest-growing companies in the U.S. and this may be your opportunity to join us! 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