Sr Contract Specialist
Sr. Contract Specialist
This role will negotiate and manage high performing provider and vendor partnerships. The Senior 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 onboarding and ongoing relationships; ensure all necessary documentation and information are included and maintained.
- Draft and revise contracting language 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.
- Perform market research and analysis to facilitate successful contract negotiation.
- Define, initiate, and direct financial analyses and operational reporting for assigned vendor and provider agreements.
- Lead, manage, and track ongoing financial and operational success of designated partnership.
- Develop and initiate corrective action plans or agreement modifications where necessary, coordinating with internal teams.
- Initiate and lead meetings with internal and external contacts, including executive management, to review vendor and provider agreement performance data and scorecards, and partnership strategy.
- Research state regulations and statutes, review of contracts and Requests for Proposal (RFPs), and development of appropriate language to support new products/markets to support new business needs.
Required Knowledge, Skills and Abilities:
- Bachelor’s degree in Finance, Healthcare Administration, Business Administration, or related field or equivalent experience.
- 4+ 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 at senior levels.
- Experience with health care provider negotiations for self-insured plans including Reference Based Pricing.
- Knowledge of Javelina benefits administration software preferred.