Provider Contracting Executive

Responsibilities

• Plays a key role in establishing and maintaining strong effective relationships with providers.
• Serves as the liaison between UUHP and the provider organization, medical group and other healthcare providers.
• Negotiates low-volume, single-department, letter of agreements and invoice settlements with providers.
• Ensures all contracts are properly drafted and executed.
• Collaborates with multiple departments to ensure contract terms and provisions are effectively communicated and implemented.
• Serves as a resource to assist with escalated billing and policy issues.
• Conducts reimbursement analysis to determine financial impact.
• Conducts an analysis of potential network providers to assess potential business compatibility.
• Audits and troubleshoots negotiated reimbursement terms with claims and contract compliance systems.
• Maintains current knowledge of appropriate contractual provisions and of government regulations related to the establishment and maintenance of contractual arrangements.
• Represents provider relations and contracting department at meetings.

Requirements

• Strong oral and written communication skills to effectively communicate with a broad array of internal and external contacts.
• Proven ability to build and maintain positive relationships.
• Knowledge and understanding of the provider community and principles of healthcare delivery systems.
• Self-motivated with effective time management skills.
• Working knowledge of healthcare operations and billing principles.
• Good analytical and problem solving abilities.
• Experience using word processing, spreadsheet, database, internet and e-mail applications.