Provider Contract Specialist Lead

Job Summary

Lead by example, holding positive and respectful relationships with highly-valued and complex internal and external customers. Understand the nuances of managed care contracting, analytics, managed care payers, delivery system’s primarily operations, functions of a revenue cycle, and know where and when it is appropriate to engage senior leaders. Understand the latest healthcare trends and leverage past years of experience to creatively design contracts that add value for Corewell Health.

Essential Functions

• Manages the contract development and negotiations process for delivery system network initiatives.
• Enters/maintains/oversees current information in the internal contract repository and system contract database.
• Leads the proactive, methodical management of contracts from initiation through execution, compliance and renewal.
• Creates contracting strategies and deploys techniques that move payers to desired contract terms according to guidelines and preferred language.
• Provides effective oversight of contract implementation process ensuring all contracts are within required guidelines and financial parameters and timely.
• Led the drafting, review, negotiation, and execution of assigned payer contracts from start to finish.
• Develops regular reports on contract milestones and performance; and informs internal customers of activities and progress, through both verbal and written communications.
• Interfaces routinely with leadership on an independent basis while understanding other political sensitivities.
• Applies critical thinking skills to analyze complex situations, identify root causes, and evaluate alternative solutions.
• Investigates operational, clinical, or administrative issues by gathering relevant data, conducting interviews, reviewing documentation, and assessing system processes.
• Formulates logical, evidence-based conclusions and make sound recommendations to resolve problems or improve outcomes.
• Collaborates with cross-functional teams to develop and implement corrective actions, ensuring alignment with organizational policies and goals.
• Makes sure the effectiveness of implemented language and renegotiates as needed.

Qualifications

• Bachelor's Degree or equivalent in Business Administration, Health Care Administration, Finance, Health and Human services or related degree programs.
• At least 10 years of experience within the healthcare system in either a payer or provider capacity in a direct, outward-facing role that includes data analytics.
• Relevant experience in finance or contract management.
• PREFERRED: Masters Degree in business administration, health care administration, finance, health and human services.
• Preferred: Experience in a team lead or project management role responsible for personnel and their success.
• Preferred: Experience working with legal staff.
• SKILLS: in best practices for contract negotiation tactics and strategies; Working knowledge of anti-trust laws.

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

Corewell Health

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Days Worked

Monday to Friday

Hours of Work

8:00 a.m. to 4:30 p.m.

Current Corewell Health Team Members Only

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Corewell Health

• Committed to providing a safe environment for our team members, patients, visitors, and community.
• Requires a drug-free workplace and requires team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category.
• Grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
• Encourages an interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization.
• Dedicated to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
• Invites those that share in our commitment to join our team.
• Requests assistance in completing the application process by calling 616.486.7447.