Senior Hospital Contracting Strategist
New
H
HumanaHealthcare
United States, 8am to 5pm ESTFull-TimeSenior
Salary$78,400 - $107,800 per year
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Job Details
- Experience
- 5 or more years of Hospital negotiation experience in Medicare; 5 or more years of progressive network management experience
- Required Skills
- Microsoft ExcelFinancial analysisPowerPoint
Requirements
- Bachelor's degree
- 5 or more years of Hospital negotiation experience in Medicare
- 5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
- Experienced in negotiating managed care contracts with Hospital systems inclusive of post acute, ancillary providers and physicians
- Analyze, understand and communicate financial impact of contract terms, payment structures and reimbursement rates to providers
- Understand and interpret Hospital contract language
- Proficient in Microsoft Office: Word, Excel and PowerPoint
- Minimum internet download speed of 25 Mbps and upload speed of 10 Mbps for remote work
- Dedicated workspace to protect member PHI / HIPAA information
Responsibilities
- Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements
- Evaluate reimbursement methodologies, including DRG, PD, Case Rates, POC, OP fee schedules, and alternative payment arrangements
- Partner with Finance, Medical Economics, Legal, Network Management, Claims, Configuration, and Operations to ensure contracts are financially sound and operationally executable
- Communicate contract terms, payment structures, and reimbursement rates to providers
- Analyze financial impact of contracts and terms
- Maintain contracts and documentation within a tracking system
- Help with identifying and recruiting providers based on network composition and needs
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