(Position can he on-site or hybrid).
This role will support negotiation and management of high performing provider and vendor partnerships. The Contract Specialist will engage physician, hospital, and other service providers to sign network and / or pricing participation agreements.
Duties and Responsibilities:
- Negotiate vendor or provider contracts and manage on-boarding and ongoing relationships; ensure all necessary documentation and information are included and maintained.
- Suggest revisions to contracting language for review to support mandated language, product requirements, language deviations received from negotiators or providers, and other contract language requests.
- Facilitate and oversee provider set-up based on contract language to ensure accurate claims adjudication.
- Assist with market research and analysis to facilitate successful contract negotiation.
- Define, initiate, and direct financial analyses and operational reporting for assigned vendor and provider agreements.
- Support ongoing financial and operational success of designated partnership.
- Develop and initiate corrective action plans or agreement modifications where necessary, coordinating with internal teams.
- Participate in review of vendor and provider agreement performance data and scorecards, and partnership strategy.
- Aid management in new business needs including research of state regulations and statutes, review of contracts and Requests for Proposal (RFPs), and development of appropriate language to support new products/markets.
Required Knowledge, Skills and Abilities:
- Bachelor’s degree in Finance, Healthcare Administration, Business Administration, or related field or equivalent experience.
- 2+ years of contracting, contract analysis, provider relations or provider experience in a hospital or other healthcare setting.
- Experience negotiating contracts with successful outcomes and measurable financial results.
- Experience with presenting and communicating negotiation strategies and results.
- Experience with health care provider negotiations for self-insured plans; Reference Based pricing experience preferred.
- Knowledge of Javelina benefits administration software preferred.