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Senior Contracting Speciaist

Company: Mercy Health
Location: West Des Moines
Posted on: February 15, 2019

Job Description:

Job Summary: The managed care Senior Contracting Strategist will work closely with the Payer Strategy and Market representatives to negotiate the terms and conditions of Payer Agreements on behalf of Mercy Health Network (MHN) and other related ventures in the market area. MHN generates approximately $3 billion in annual net patient service revenue with more than 50 hospitals (owned and managed in total) and over 2,000 employed and clinically integrated providers. Primary focus of contract support and negotiations will be to ensure the terms and conditions of the payer contracts adhere to the MHN Standards and Guidelines, represent industry best practices for fee for service and value-based arrangements, and align with strategic objectives .
Essential Position Expectations:

  • Review contract proposals to ensure compliance with Standards and Guidelines. Monitor compliance with contract rates and terms, and research and assist implementation of negotiated resolutions.
  • Identify payer contract language opportunities and negotiate to implement and coordinate organization responses.
  • Lead negotiations on various payer contracts and single pricing agreements for hospitals, professionals, and ancillary providers.
  • Mentor and provide research assistance to associate members of the managed care team.
  • Answer contract related questions from local and market staff members.
  • Participate and engage in negotiations of high valued agreements including but not limited to: hospitals, professional services, home care service, hospice, ambulatory centers, skilled nursing, behavioral health, rehabilitation and durable medical equipment.
  • Assist with ensuring that hospital, professional, and ancillary contract terms can be operationalized by organization prior to final approval of agreement.
  • Communicate and participate in implementation of contract terms, amendments, and policy changes resulting from the corporate, legal/legislative, operational, and regulatory environments.
  • Maintain managed care library of contracts and communiques Education: Bachelor's Degree in Finance related field is preferred or 5 years related experience Experience: Five (5) years of negotiation or sales experience in a healthcare reimbursement environment. Previous experience in the managed care contracting industry is highly preferred. Certifications & Licenses: N/a
    Additional Information
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