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Manager Provider Contracts

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Renton, WA

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Job description Theideal candidate has career experience and a skill set that willnsupport and enable a strong understanding of providernnetwork contracting strategy related to development and maintenancenof market competitive provider agreements. Manage the providerncontracting process from service delivery planning throughnimplementation, including ongoing monitoring and evaluation. Act asnlead negotiator for the Provider Relations/Delivery System team andnwrite contractndocuments.  Acts as lead negotiator (e.g.nproposal development & execution) for the Provider Relations/nDelivery System team in negotiations with community providers (e.g.nhospitals, multi-specialty groups, large for-profit vendornorganizations, skilled nursing facilities, etc.).n Authors the contract document andnensures the complete & appropriate implementation ofncontractual arrangements, in accordance with payment policynand business & system requirements.n Identifies, recommends andnfacilitates timely resolution of provider training &nenhancement strategies to achieve maximum value from contractednrelationships. Facilitates problem resolution strategies involvingna variety of departments including Legal, Claims,nMembership Patient Financial Services, Delivery System, ProvidernServices, etc. Reviewsnand approves all contracted provider network information prior tonpublication/ marketing. nConducts and/or oversees financial modeling and recommendsnfinancial terms meeting payment policy and divisional objectivesnof  Delivery System leadership.n Provides knowledge, information,nconsultation and decision level recommendations to inform servicendelivery planning, provider selection and retention process. Servesnas single point of contact between Provider Relations andnaccountable delivery system divisional management on a service linenbasis.  KPWAHTAdvancednworking knowledge of various reimbursement methodologies, includingnquality improvement and risk arrangement. Strong analytical skillsnrelated to medical expenses and utilization.Demonstratednability to effectively work independently and as part of a team asnneeded, with a variety of internal and external personnel atnvarious levels of responsibility. Strong verbal and writtenncommunication and customer service skills. Strong projectnmanagement, leadership, facilitation andninterpersonal skills.ExperienceMinimum ExperiencenRequirements4 years Health carenexperience with at least 1 year healthcare/medical/insurancencontract negotiations experience.Preferred Experience7nyears Additional health care and an additional 4 years ofncontract negotiation experience and delivery system operationsnexperience.Who does this position reportnto?Director of Provider Contracting / ProvidernRelationsWhat are the 3-4 non-negotiable requirementsnon this position?• Ancillary ServicesnContracts Negotiation experience. To be clear, client actually ownsn26 ambulatory clinic properties so we must contract with othernprovider groups for ancillary services like lab, radiology, eyencare, pharmacy, etc. Advanced Working knowledge of variousnhealthcare reimbursement methodologies, including qualitynimprovement and risk arrangement.

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