Contract Negotiator Senior at AdventHealth

Date Posted: 11/11/2020

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Maitland, FL
  • Date Posted:
    11/11/2020
  • Job ID:
    20022844
  • Job Family
    Managed Care
  • Travel
    Yes, 25 % of the Time
  • Shift
    1 - Day

Job Description


Description

Senior Contract Negotiator AdventHealth Corporate

Location Address: 1051 Winderley Place Suite 400 Maitland, FL 32751

Top Reasons To Work At AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential
Work Hours/Shift:
  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Represents AdventHealth as lead negotiator for assigned top-tier and mid-level tier managed care health plans in facilitating contract negotiations with AdventHealth business divisions to further AdventHealth strategic, tactical, and operational goals.
  • Assumes the role of a subject matter expert during contract negotiations by displaying proficiency and distinction related to managed care and contract negotiation topics with the intention of maintaining strategic alignment with contracted health plans.
  • Seeks resolution to managed care issues by collecting and interpreting contract performance information (e.g. claims volumes, quality and efficiency reports, participation gap analysis, accounts receivable data, etc.) to preserve the integrity of those contracts.
  • Exhibits research proficiency using applicable reports (e.g. financial statements, impact analyses, database systems, etc.) to effectively lead in contract negotiation and issue resolution.
  • Coordinates with multiple internal teams (e.g. Contract Management, Finance, etc.) and external teams (e.g. PFS, Pre-Access, etc.) to ensure that contracting information is correct and up to date in all applicable Managed Care documentation and resources.
  • Assumes responsibility as a managed care liaison to assigned AdventHealth providers by leading or contributing as needed to contracting strategy development and implementation for the purposes of advancing the initiatives of those providers within the overall scope of AdventHealth managed care strategy.
  • Refines ongoing managed care processes by developing information and documents such as contract language and negotiation strategies for the purpose of enhancing performance standards in the Managed Care department.


Qualifications
What You Will Need:
  • Bachelor’s Degree in healthcare or related field, or equivalent work experience
  • Seven or more years’ experience in healthcare or insurance
  • Minimum of five years training or experience in contract negotiations and/or contract administration and implementation
  • Master’s degree in healthcare or related field, preferred
  • Five or more years’ experience working with multi-hospital integrated delivery healthcare system, preferred
 
Job Summary:

This position is responsible for direct and indirect negotiation, review, and completion of assigned top-tier and mid-level tier payer contracts. Duties as assigned include leading strategic managed care contracting initiatives as directed by AdventHealth leadership; managed care contract review, interpretation and analysis, negotiation, reporting, implementation for assigned mid-level and top tier payer contracts; and issue resolution across multiple entities including hospitals and/or physician practices in Florida as well as ancillary service providers owned, employed, or operated by AdventHealth. Facilitates compliance of contract terms for assigned payers by leading in strong working relationships with department staff, various hospital and provider staff, and leadership at all AdventHealth Florida markets, providers, and external managed care payers. Actively participations in outstanding customer service and serves as a primary liaison for maintained relationships that are equally respectful of all. Diligently manages the business relationship and advances AdventHealth strategic and tactical objectives with each assigned payer.



This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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