PracticeMax
  • CRED/PROVENR
  • Scottsdale, AZ, USA
  • Full Time

Reports to: VP of Contracting and Credentialing

 

Objective: This position is responsible to successfully manage multiple contracts and contracting projects utilizing skills such as attention to detail, accuracy, accountability, confidentiality, dependability, high level of productivity and timeliness.

Essential Duties:

  • Collaborate with Contracting VP & team, Healthcare Practices and Billing Operations to identify contracting objectives and the strategies to be used to achieve them.
  • Manages contract requests (in and out bound) from initiation through negotiation and execution as well as subsequent document filing, communication and monitoring in order to ensure adherence and timely renegotiation. The CS evaluates, implements, negotiates, and monitors contract language, rates and terms for healthcare services provided by multiple practices in fee-forservice, value-based, or risk arrangements and in accordance with contracting parameters established with the client.
  • Develops, initiates and negotiates financial terms to managed care and third party payor's on behalf of healthcare practices.
  • Effectively interact with payor's to gain a thorough understanding of proposed or countered reimbursement rates and logic to facilitate rate modeling to ensure contract terms and rates are fully understood and viable for contract acceptance.
  • Effectively works in conjunction with Client and Operations team to identify problems and opportunities for improvement (i.e. adjudication/payment issues) and generate creative solutions that improve the quality and/or value of the contract.
  • Modify and/or identify strategies as needed to overcome closed panels, rate increase request rejections, low offers, unfavorable terms, etc. in order to receive contract offers and achieve and/or exceed Client objectives.
  • Manage numerous contracting projects simultaneously with swift completion

 

Preferred Skills/Qualifications:

  • Minimum of 3 years' experience with contract negotiations within the healthcare or insurance payer industry
  • Strong written and verbal communication skills
  • Project and time management skills and software experience beneficial
  • Familiarity with fee schedule and financial impact modeling
  • Medium to advanced level Excel skills
  • Multiple Healthcare specialty experienced preferred
PracticeMax
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