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Contracting Specialist
3 months ago
Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.
What awaits you:
- Work-life balance - This is a hybrid role requiring you to come in only 1 day per week
- Medical, Dental, and Vision Insurance.
- 403B Savings Plan w/employer contribution.
- Paid Time off & Paid holidays.
- Employee and Dependent Tuition assistance benefits.
- Health and wellness programs and MORE
As a Contracting Specialist for JHHP, you'll:
- Be responsible for maintaining a primary responsibility for the development of provider networks that includes recruitment, negotiating complex contracts, contacting, and re-contracting of current provider network.
- Be responsible for reviewing network adequacy and determining recruitment needs within all specialties, taking appropriate actions to recruit new providers to fill in gaps to meet accreditation standards and JHHP's strategic initiatives, and negotiating within the financial parameters to gain maximum cost efficiency and support JHHP's goals and strategic initiatives.
- Be responsible for the network development and retention of a network of physicians/facilities/ancillaries to ensure each territory meets network adequacy and access guidelines to meet regulatory standards.
- Contract with health systems to ensure JHHP is reimbursing at industry standard.
What you'll bring:
- 3+ years prior experience in Contracting/Network Development in healthcare delivery program or insurance setting, experience in developing various reimbursement standards.
- Bachelor's degree in business management or healthcare administration or related discipline preferred.
- Proven ability to negotiate high dollar reimbursement, sound knowledge of successful selling, and negotiation techniques and an awareness of healthcare contracting terms. –
- Strong ability to develop unique alternative reimbursement standards that are cost efficient.
Who we are:
Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
