Healthcare Contracting Specialist

4 weeks ago


Southfield, Michigan, United States My career Full time
About the Role

The Value-Based Care and Contracting Manager will be responsible for driving strategies to optimize value-based reimbursement opportunities and managing payer relationships.

This position involves negotiating contracts, overseeing Accountable Care Organization (ACO) initiatives, and ensuring compliance with healthcare regulations.

The role requires close collaboration with various internal teams and external stakeholders to enhance financial performance, improve patient outcomes, and maintain regulatory compliance.

Key Responsibilities:

  • Analyzing financial and operational data to help the organization stay competitive in the evolving healthcare landscape.
  • Negotiating contracts with payers to secure optimal terms and maximize reimbursement.
  • Overseeing ACO programs, focusing on performance management, compliance, and enhancing the quality of care and patient satisfaction.
  • Establishing policies and procedures to ensure compliance with federal, state, and local laws related to value-based care and ACO operations.
  • Conducting thorough data analyses of financial and reimbursement trends, preparing reports for senior leadership, and providing strategic insights to guide decision-making.

Requirements:

  • Bachelor's degree in healthcare administration, business, finance, or a related field.
  • Minimum of five years of experience in healthcare administration, value-based reimbursement, payer relations, or ACO management.
  • Strong ability to negotiate contracts, manage payer relationships, and perform financial analysis within a healthcare environment.
  • Excellent communication and negotiation skills, with the ability to balance multiple priorities in a dynamic setting.


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