Principal Consultant System Contracting
Duties:
Job Summary:
This position is responsible for supporting the System Contracting department by providing payer contracting subject matter expertise and performing special project as determined by the Vice President of System Contracting and the Director of Managed Care Contracting. Assignments would include providing consultation on, leading and/or performing; complex payer negotiations, financial model development, analytics, and cross-functional system projects and initiatives.
Serve as project manager and execute assigned projects. Projects will include complex cross-functional strategic initiatives and payer negotiations.
Perform analytical functions to evaluate contract performance of fee for service and value based contract terms to support payer negotiations, collaborating with Payors and system colleagues as needed.
Serve as subject matter expert on payer contract terms, payer relationships and strategies, fee for service reimbursement terms and value based financial models. Provide consultation to and educate others within the organization on such subject matter.
Support strategic initiatives as assigned, including leading or supporting cross functional teams to drive improved performance and evaluate opportunities.
Effectively coordinate and collaborate with System Contracting and other areas within the organization including Primary Health, Reimbursement, Revenue Cycle, Finance, and Analytics.
Prepare and present deliverables for executive leaders.
Effectively manage multiple projects and assignments occurring at the same time.
Perform other responsibilities or assignments as required.
null Skills:
Required Skills & Experience:
Minimum ten (10) years of experience in healthcare industry.
Minimum seven (7) years of experience in Payer Contracting, with at least three (3) years of
experience with value based contracting terms.
Comprehensive project management abilities.
Excellent oral and written communication and presentation skills.
Excellent organizational skills and ability to manage multiple projects simultaneously.
Excellent interpersonal skills and ability to develop effective working relationship with
both internal and external customers.
Strong negotiation skills.
Understanding of legal, business, and insurance operations principles.
Proficient in Microsoft Word, Excel, and PowerPoint. Must meet or exceed core customer service responsibilities, standards and behaviors as outlined in the company\'s Customer Service Policy and summarized below:
Communication
Ownership
Understanding
Motivation
Sensitivity
Excellence
Teamwork
Respect Must practice the customer skills as provided through ongoing training and inservices. Must possess the following personal qualities:
Be selfdirected.
Be flexible and committed to the team concept.
Demonstrate teamwork, initiative and willingness to learn.
Be open to new learning experiences.
Accepts and respects diversity without judgment.
Demonstrates customer service values. Preferred Skills & Experience:
N/A null Education:
Required Education:
Bachelors Degree in Accounting, Finance, or a related field. Preferred Education:
Masters Degree Required Certifications & Licensure:
N/A Preferred Certifications & Licensure:
N/A
null Languages:
English Read Write Speak
Recommended Jobs
Physical Therapy Technician
Job Description Job Description Benefits: Flexible schedule Training & development Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opportunitie…
Lead ESL Instructor
Job Title: Lead English as a Second Language (ESL) Instructor Job Status: Full-time Job Summary: Under limited supervision, the Lead English as a Second Language (ESL) Instructor uses intermediate s…
Great Lakes Master (Captain)
Job Description Job Description Description: Come Sail with us on the Great Lakes! If you are looking to sail with us as part of our team, safety, efficient operations, a family-oriented env…
Home Health Care Marketer / Liaison (Field-Based Sales Role)
Job Description Job Description Guardian Angel Home Care Compensation MI, IL, OH: $45,000 – $70,000 base + uncapped performance bonus CA, NV (Las Vegas): $55,000 – $80,000 base + uncap…
Med Surg RN
Job Description Job Description Medical-Surgical Registered Nurse (Med Surg RN)???? Detroit, MI Join a dynamic Patient Care Services team and make a meaningful difference in one of Detroit’…
Civil Estimator
Job Description Job Description Salary: Founded in 1963 by Don Fessler & George Bowman, Fessler & Bowman, Inc. has grown from a residential flatwork & basement wall contractor to a top 100 Com…
Plumbing Manager
At Great Dane Heating, Cooling, Plumbing & Electrical, we’ve built a reputation for excellence in home services. As we are expanding our residential plumbing, we’re looking for a seasoned, hands-on P…
CDL-A Truck Drivers Out & Back Lanes
CDL-A Drivers Out & Back Lanes * Home Often Avg $1300 weekly $1500 Sign-on Pay New Pay Increase & Safety Bonus Full Benefits * Paid Orientation & Training No Endorsements Needed Immediate Hiring…
Commercial Lines Account Manager
Job Description Job Description We are seeking a Commercial Lines Account Manager to become a part of our agency! Responsibilities: Develop insurance quotes, prepare applications for commerc…
Mover / Helper
+ View details