Contract Negotiator - Managed Care/Healthcare Financial Services

ID 2024-31498
Location
White Box
Work Location
US-NC-Greensboro
Division : Name
System Wide
Department : Name
SW-Managed Care Contract
Category
PROFESSIONAL/MNGMNT
Position Sub-Category
FINANCE
Position Type
Full Time (40 hours/week)
Employment Type
Employee
Exempt/NonExempt
Exempt
FTE
1.00
Workforce Status
Fully Remote
Work Hours
40.00
Provider Schedule (specific schedule)
Monday - Friday (8:30am - 5:00pm)
On call Required
No
Sub Category
Finance

Overview

The Contract Negotiator plans and directs managed care operational practices including analyzing, developing strategy, negotiating, and maintaining system wide Managed Care agreements. This role is responsible for establishing and maintaining relationships with managed care payers and internal stakeholders. The Contract Negotiator produces reports concerning managed care contract performance and operations and facilitating resolution of contractual and operational issues with payers to enhance managed care contract performance. Working under general supervision, this role monitors and updates management on political, legal, and regulatory trends with respect to managed care.

Responsibilities


Leads all aspects of negotiations for facility, physician and network managed care agreements under general supervision from management.
Coordinates, analyzes and develops all financial and operational aspects of contract proposals, including drafting and redlining agreements and amendments.
Develops a negotiation strategy for each managed care payer, assessing the strengths of each party in the negotiation.
Evaluates and enforces contract compliance.
Prepares correspondence to managed care payers.
Owns contract management process to include loading into contract management system and preparation of contract summaries outlining contract terms for internal stakeholders.
Establishes and maintains relationships with managed care payers.
Acts as a professional resource to answer all contractual questions and facilitate issue resolution with internal and external stakeholders.
Assists with development and maintenance of reports used to track contracting activity and report outcomes.
Performs other duties as assigned.

Qualifications


EDUCATION:
Required: Bachelor's Degree

EXPERIENCE:
Required: 4 years of negotiation experience in managed care or a related field (such as healthcare finance or patient financial services) with a healthcare provider or insurer/payer

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

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