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.
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.