NOTE - This Position is Hybrid with a minimum of three days on site per week
Job Description:
Under the direction of the Director of Managed Care Contracting and Provider Relations, this individual is responsible for managing the payor contracting functions for Hunterdon HealthCare Partners.
Major Responsibilities
â— Craft, evaluate, negotiate and execute a wide variety of different contracts covering a
range of transactions for hospital and physician entities.
â— Create and maintain relationships with external stakeholders (payers) and internal
stakeholders (billing, finance, legal, physicians, administration).
â— Maintain records for correspondence and documentation in relation to established
contracts and those in progress; ensure contract library remains current.
â— Communicate and present information to stakeholders about all contract-related
matters.
â— Solve any contract-related problems that may arise with other parties and internally
with the company itself; this includes tracking and monitoring data as it relates to
outstanding settlements/projects for payer payment issues.
â— Manage and maintain reporting regarding payor trends, contract compliance and
contract modeling.
â— Manage existing contracts to ensure negotiated rates are achieved.
â— Routinely evaluate current contracts for appropriate reimbursement terms and
renewals to ensure compliance with industry standards.
â— Resolve provider enrollment issues with contracted payers.
Skills and Abilities
â— Four to seven years’ experience in responsible positions in healthcare or health plan
environment, with financial and managed care contracting experience.
â— The individual must have experience in the negotiating/contracting process including a
strong ability to organize and prioritize activities while ensuring attention to details.
Education Requirements
â— Bachelors degree in Business or a related field and five (5) years of related experience
required.