Skip navigation
Contracting Specialist-KY
Advertisement
 

Contracting Specialist-KY

Job Description

Job Summary: 

The Managed Care Contracting Specialist will work closely with the Regional Director of Payer Contracting to negotiate the terms and conditions of Payer Agreements for facility, professional, and ancillary agreements.  Primary focus of contract support and negotiations will be to ensure the terms and conditions of the payer contract adhere to the CHI Standards and Guidelines, represent industry best practices for Fee for Service and value based arrangements, and align with operational objectives.   

 

Essential Duties:

1.    Review contract proposal to ensure compliance with CHI standards and guidelines

2.    Recommend language opportunities to Director

3.    Lead negotiations on small valued ancillary agreements as supervised by Director

4.    Participate and engage in facility and professional agreements with Director Payer Contracting

5.    Help verify Facility and professional contract terms can be operationalized by organization prior to final approval of agreement.

6.    Help communicate and operationalize contract terms, amendments, and policy terms.

7.    Help organization identify and quantify operational the financial impact of policy change and coordinating organization response.

8.    Adhere to all established contracting guidelines. Contracts for negotiation include: physician services, home care service, hospice, and hospital.

Job Requirements

Education:

Bachelor’s degree required. Will consider experience in lieu of education.

Experience: 

This position requires knowledge and experience in reimbursement, the financial aspects of contracting and managed care operations. Additionally, good negotiation skills, excellent written and verbal communication skills and expertise & experience with PC applications are required. Five (5) years of negotiation or sales experience in a healthcare related field is required.   Adequate conversational English is required in order that the individual be able to take direction from management, understand how to complete job tasks, communicate adequately with co-workers as necessary, understand and follow safety guidelines, and understand all policies 

Additional Responsibilities:

  • Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
  • Adheres to and exhibits our core values:
    Reverence: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.
    Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
    Compassion: Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.
    Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
  • Maintains confidentiality and protects sensitive data at all times.
  • Adheres to organizational and department specific safety standards and guidelines.
  • Works collaboratively and supports efforts of team members.
  • Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.
Catholic Health Initiatives and its organizations are Equal Opportunity Employers. CBCHI




  • Shift:  1st

  • Scheduled Hours per 2-week Pay Period:  80

  • Weekends Required:  None

  • Status:  Full Time
  • Job Snapshot

    Employment Type Full-Time
    Job Type Legal
    Education 4 Year Degree
    Experience Not Specified
    Manages Others Not Specified
    Industry Healthcare - Health Services
    Required Travel Not Specified
    Job ID 1400016757
    CareerBuilder Tip:
    For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.

    By applying to a job using CareerBuilder.com you are agreeing to comply with and be subject to the CareerBuilder.com Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.

    Contracting Specialist-KY


    Enter notes about this job:

    Cancel