OVERVIEW OF POSITION:
Responsible for the identification and negotiation of contracts with ancillary providers and hospitals, in geographically diverse areas for both existing and developing provider networks. Ensure proper administration of the contracts through coordination with regional HCP leadership, assessment of provider needs, coordination of contract documentation, and interfacing with Claims, Care Management, and other departments.
* Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
* Assesses and completes provider contracting needs for all provider operations.
* Provides guidance to Contract Specialists, Contract Coordinators and/or other staff in the absence of Director, Provider Contracting.
* Prepares supporting documentation, negotiates and implements contracts of hospitals, skilled nursing facilities, and other ancillary providers in geographically diverse areas for both existing and developing provider networks.
* Coordinates the completion of provider pre-contractual activities including the submission of relevant provider contract documentation, completion of RFP and application information, financial analysis, credentialing, etc.
* Prepares and/or coordinates financial and utilization analyses to develop recommendations for compensation methodologies and amounts, including capitation.
* Cultivates positive working relationships with network Medical Directors and other administrative staff.
* Develops and maintains client relationships and ensures continuing client satisfaction.
* Assists in constant analysis of contracting needs.
* Negotiates patient-specific Letters of Agreement.
* Responds to correspondence and other communication in a professional and timely manner.
* Coordinates contract documentation to ensure timely re-negotiation of existing contracts.
* Uses, protects, and discloses HCP patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
* Performs additional duties as assigned.
* Bachelors degree preferred
* Exceptions for candidates with significant relevant experience
* 5 years of healthcare experience in contracting and/or contract management
* Experience contracting with ancillary services providers highly preferred
* Experience navigating updated CMS fee schedules, and understanding of CMS competitive bidding process
* Experience redlining contract language in Word preferred
KNOWLEDGE, SKILLS, ABILITIES:
* Computer literate
* Knowledge of Microsoft applications (Excel, Word)
* Excellent verbal and written communication skills
* Ability to work independently
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