Payer Strategy Contract Specialist

3 days ago


Englewood, Colorado, United States CommonSpirit Health Full time
Job Title: Payer Strategy Contract Specialist

CommonSpirit Health is seeking a highly skilled Payer Strategy Contract Specialist to join our team. As a key member of our Payer Strategy team, you will play a critical role in supporting the negotiation of terms and conditions for Managed Care payer contracts for facility, professional, and ancillary entities.

Key Responsibilities:
  • Support the review of contract proposals, language, and rate sheets to ensure accuracy, completeness, and compliance with CommonSpirit Health standards and guidelines.
  • Recommend corrections, changes, and language opportunities in documents to PSR leadership.
  • Assist PSR leadership with developing and updating project plan documents, meeting minutes, and action item follow-up related to National Payers renewals and planning.
  • Ensure all amendments, letters of agreement (LOA), memorandum of understanding (MOU), and other contract documents are signed by the appropriate parties and provide the fully executed contract documents to the Contract Administration team.
  • Ensure contract documents include rate escalators and obtain updated rate tables, fee schedules, and all contracting materials are stored according to PSR and/or Legal Policies, and ensures information is made available to or disseminated to key stakeholders of the negotiation process.
  • Coordinate with other PSR team members to facilitate credentialing and re-credentialing of CSH entities.
  • Maintain complete and up-to-date inventory of all CSH hospitals/specialty hospitals to include demographic information, license, NPI, Tax ID information, etc.
  • Assist in communicating and operationalizing contract terms, amendments, and policy terms.
  • Maintain National Payer knowledge base to include financial statements/reports, news articles, and other information.
  • Adhere to all established contracting guidelines. Contracting accountability for negotiation support includes hospital, physician, and ancillary services.

Qualifications:

  • Bachelor's degree or equivalent education and experience.
  • Minimum of three (3) years contract experience in a healthcare-related field.
  • Payer or Managed Care experience strongly preferred.


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