Healthcare Contracting Specialist

3 weeks ago


Springfield, Massachusetts, United States Health New England Full time
Job Overview

We are seeking a skilled Healthcare Contracting Specialist to join our team at Health New England. This role is responsible for negotiating and maintaining provider contracts, including hospital renewals, negotiations, analysis, and day-to-day service issues and operations.

Key Responsibilities:
  • Negotiate and maintain Fee For Service and Value Based contracts for hospitals, physicians, physician groups, and PHOs.
  • Take the lead on day-to-day hospital, IPA, PHO, or other Provider organization inquiries and contract changes as they arise in written format, by phone, and via email.
  • Collaborate with Contracting Director and Manager to develop contracting strategies, including financial models such as physician fixed payment models.
Ancillary Providers and Individual or Small Group Providers:
  • Negotiate and maintain provider contracts, including ancillary providers, non-acute facilities, individual, and small group providers.
  • Evaluate and monitor provider network adequacy, provider accessibility, and payment rate parity by major provider type.
  • Makes recommendations for provider network additions/consolidations/terminations or changes in payment arrangements.
Vendor Relationships:
  • Assume ownership of assigned provider related vendor contracts and provider related vendor relationships to resolve provider related vendor payment and day-to-day service issues.
Requirements:
  • Bachelor's degree in Business, Allied Health, or related field with 3 or more years of experience in provider contract negotiations in a managed care environment.
  • Knowledge of multiple provider contracting models and arrangements.
  • Strong analytical skills with Excel, effective communication and presentation skills, both written and verbal.
Estimated Salary:

$85,000 - $110,000 per year, depending on experience.



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