All roles

Insurance Contract Administrator - Full Time- Remote/Hybrid

Remote · USA Full-time New today

To develop, maintain, implement and monitor contractual relationships with third party Insurance Payors on behalf of HFHS and its business units. PRINCIPAL DUTIES AND RESPONSIBILITIES : 1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units. 2. Independently evaluate and analyze contract proposals including completing initial proposal responses and reviewing / revising contract language and operational requirements. Reviews contracts with in house legal-council and works through contract revisions with Payors. 3. Routinely monitor current contracts for appropriate rate structure, contract terms and annual renewals and / or re-negotiations and compliance with industry standards and guidelines. 4. Monitor marketplace for new contracting opportunities and make recommendations of changes to enhance HFHS contract portfolio. 5. Coordinate implementation of Payor arrangements and provide ongoing education and support throughout HFHS. 6. Collect and communicate relevant contractual requirements and issues to internal customers such as Utilization Management, Finance, Patient Billing, Administration, Legal, etc. Information includes; payor relationships, operational requirements and contract terms. 7. Maintain comprehensive files of HFHS contractual relationships and update contract information in the contract database. 8. Maintain contract summaries on HFHS website (Henry). 9. Act as liaison between HFHS and Payors on contracting and operational issues, i.e. billing, utilization review, credentialing site visits, notification of site closures or new services. 10.Coordinate facility credentialing and re-credentialing. 11.Perform other duties as assigned. EDUCATION / EXPERIENCE REQUIRED : • Bachelors Degree in Business, Healthcare or related field. • Minimum of four years in the healthcare industry in a professional capacity. • Knowledge of managed care organizations and integrated health systems. • Previous contracting, provider relations and / or provider reimbursement experience. • Comprehensive project management abilities. • Excellent oral and written communication and presentation skills. • Excellent organizational skills and ability to manage multiple projects simultaneously. • Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers. • Strong negotiation skills. • Understanding of legal, business, and insurance operations principles. Proficient in Microsoft Word. PHYSICAL DEMANDS / WORKING CONDITIONS : • Normal office environment with minimal exposure to noise, dust, or extreme temperatures. LI-VD1 Additional Information Organization : Corporate Services Department : Managed Care Contracting Shift : Day Job Union Code : Not Applicable Apply Job!

Related roles

Accounting Manager - Non Profit (Hybrid Remote)

Remote · USA Full-time

R-107071 Commercial Equipment Regional Sales Manager (Midwest)

Remote · USA Full-time

Investment Banking - Private Equity Career Specialist

Remote · USA Full-time

Senior Accountant/Full Charge Bookkeeper - Remote Working

Remote · USA Full-time

Senior Accountant/Full Charge Bookkeeper - Remote Working

Remote · USA Full-time

Clinical Trial Liaison (CTL), Neurology (Nationwide US)

Remote · USA Full-time

Youth Worker/Direct Care - Heartland Boys Academy

Remote · USA Full-time

Investment Analyst (Loan Ops) – Entry Level

Remote · USA Full-time

Machine Learning Engineer - Contract to Hire

Remote · USA Full-time

Principal AI Scientist - Payments Analytics Studio

Remote · USA Full-time

Creative Marketing Project Manager Job at Verizon Communications in New York

Remote · USA Full-time

Mobile Phlebotomist - Part Time

Remote · USA Full-time

National Accounts Sales Representative (Dallas, TX, US, 75237)

Remote · USA Full-time

Experienced Full Stack Case Management Social Worker - High Risk Program for Virtual Primary Care Delivery

Remote · USA Full-time

Experienced Part-Time Remote Data Entry Associate – Flexible Schedule & Competitive Pay at arenaflex

Remote · USA Full-time

Experienced Teen Customer Service Representative – Virtual Chat Support for arenaflex

Remote · USA Full-time

[Remote] Sales Engineer (Industrial Refrigeration)

Remote · USA Full-time

[Work From Home] Middle Office Operations Analyst

Remote · USA Full-time

Experienced Part-Time Remote Customer Service Representative – Delivering Exceptional Arenaflex Experiences

Remote · USA Full-time

Sales Development Program Sales Associate - Fluid Solutions

Remote · USA Full-time