Senior Hospital Contracting Strategist

About the role

Become a part of our caring community The Senior Hospital Contracting Strategist / Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital and other provider contracts and agreements for an organization that provides health insurance. You will report to the Director, Provider Contracting.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements
• Evaluate reimbursement methodologies, including DRG, PD, Case Rates, POC, OP fee schedules, and alternative payment arrangements
• Partner with Finance, Medical Economics, Legal, Network Management, Claims, Configuration, and Operations to ensure contracts are financially sound and operationally executable
• Communicate contract terms, payment structures, and reimbursement rates to providers
• Analyze financial impact of contracts and terms
• Maintain contracts and documentation within a tracking system
• Help with identifying and recruiting providers based on network composition and needs

Requirements

• Bachelor's degree
• 5 or more years of Hospital negotiation experience in Medicare
• Leading negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements
• 5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
• Experienced in negotiating managed care contracts with Hospital systems inclusive of post acute, ancillary providers and physicians
• Analyze, understand and communicate financial impact of contract terms, payment structures and reimbursement rates to providers
• Understand and interpret Hospital contract language
• Proficient in Microsoft Office: Word, Excel and PowerPoint

Qualifications

• Master's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Skills

• Extensive managed care experience with demonstrated expertise in hospital contracting, reimbursement methodologies, financial analysis, complex negotiations, provider relationship management, and leadership
• Proficient in Microsoft Office: Word, Excel and PowerPoint

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities supporting whole-person well-being

Pay

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience,