Healthcare Contracting Specialist
3 weeks ago
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.
- 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.
- 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.
- 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.
$85,000 - $110,000 per year, depending on experience.
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