Negotiation Specialist l

Join our team and make a difference! Whether you are part of our care coordination team or play a supporting role, the work our colleagues do every day enables us to collectively reach our mission of getting people the care they need when they need it. By staying committed to our core values of Think Big, Go Fast, Deliver Awe, Win Together, and Care Deeply, we can positively impact the lives of the injured workers we serve.

About the Role

The Negotiations Specialist will provide real-time support to Operations by locating out-of-network providers and/or addressing in-network providers requesting rates outside of their contract by negotiating single rate agreements or identifying in-network providers willing to accept the referral utilizing contracted rates. The Negotiations Specialist is a partner to the scheduling team, ensuring that One Call secures providers and confirms negotiated services are started timely.

Responsibilities

• Negotiation: 40%
  • Conduct negotiations with out-of-network/network providers for prospective referrals utilizing established guidelines.
  • Execute short-term agreements (i.e., Single Referral Agreements) for One Call’s referrals if we are unable to staff through One Call’s provider network.
  • Work with contracted providers that request reimbursement outside of contracted rates in conjunction with the Provider Engagement & Contracting Teams.
• Recruiting Providers: 30%
  • Effectively and timely locate an out-of-network provider that meets the operational needs of a specific referral.
  • Effectively communicate the One Call value proposition to out-of-network providers.
  • Submit interested or viable non-contracted providers to Provider Contracting for contracting opportunities.
• Compliance: 15%
  • Acquire minimum provider qualification documents at completion of Single Referral Agreement.
  • Submit Single Referral Agreement request to Provider Data Management.
  • Ensure proper notation and documentation for each assigned task is clean, clear, and concise.
• Customer Care: 15%
  • Clearly communicate dates and other instructions with the service provider(s) for negotiated files.
  • Confirm Start of Care for negotiated files.
  • Meet the established team standards, including (but not limited to) quality standards and turnaround time requirements.
  • Provide an outstanding experience to internal and external customers, where applicable.
  • Able to support various levels of management on ad-hoc requests and perform other related duties as assigned.

Requirements

• Associate’s degree, or 1-2 years of experience instead of a degree.

Skills

• Financial acumen and proficiency in negotiating with the ability to calculate margins based on client & provider pricing.
• Good understanding of One Call products and services.
• General knowledge of the workers’ compensation industry and negotiation principles.
• Excellent customer service competencies and verbal/written communication skills.
• Proficiency to operate independently on work that is often confidential.
• Computer navigation and operation skills.
• Effective people skills and sensitivities when dealing with others.
• Able to work both independently and in a team environment.
• Communicates concisely and professionally.
• Able to understand, apply, and explain concepts.
• Able to handle projects commensurate with job expectations.
• Able to analyze and solve problems using learned techniques and tools.
• Human relations, negotiation, and documentation skills.
• High attention to detail, flexibility, versatility, and dependability.
• Able to work in an environment that aligns with the company's diversity, equity, inclusion, and belonging standards.
• Demonstrate core values of Think Big, Go Fast, Deliver Awe, and Win Together.

Work Environment

• This position will be performed in the colleague’s home. Work-from-home requirements include the colleague’s ability to set up computer equipment within their home office.
• Primarily sedentary and may involve repetitive motions; the colleague must be able to remain stationary for extended periods, operate a computer and other office equipment, assess information and files stored electronically, and converse/exchange accurate information with others, simultaneously.
• The colleague must be able to discern text displayed on a monitor, input data into specific fields using a keyboard, and adjust focus to distances of up to three feet.
• The colleague must have the ability to learn new tasks, follow established processes, maintain focus, complete tasks independently, complete multiple tasks simultaneously, communicate professionally with colleagues and customers, and complete tasks in situations that require speed or productivity.
• The colleague must be able to manage moderate to significant mental stress because of, but not limited to, a dynamic and heavy workload.

Pay

This compensation range considers a wide range of factors, including, but not limited to, skill set, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate is not adjusted for geographic differential associated with the location where the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role, and compensation decisions are dependent on the facts and circumstances of each case.

Benefits

• Remote Work: We are a remote-first company, and almost all positions receive the flexibility of working from home.
• Generous Time Off: Besides 8 company holidays and 2 personal days every year, all colleagues receive a minimum of 18 days of paid time off.
• Comprehensive Benefits Package: Including medical, dental, vision, and pet insurance; 401(k) matching program; and company-paid life insurance and short and long-term disability coverage.
• Supportive Services:
  • Colleague Assistance Program that provides free counseling and financial services.
  • One Call Foundation, a non-profit arm of our company, provides colleagues financial assistance during times of unexpected hardships.