[Hiring] Managed Care Contracts Specialist @CommonSpirit Health

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

This is a remote position with a strong preference for a candidate to reside in the Eastern or Central time zones.
• Works closely with the Contract Manager and other PSR leadership to support the negotiation of terms and conditions for Managed Care payer contracts for facility, professional, and ancillary entities.
• Primary focus of contracting and negotiation support is to ensure the terms and conditions of the payer contract adhere to the CommonSpirit Health Standards and Guidelines, represent industry best practices for Fee for Service and value-based arrangements, and align with operational objectives.
• Supports the review of contract proposals, language and rate sheets to ensure accuracy, completeness and compliance with CommonSpirit Health standards and guidelines.
• Reviews and redlines contract language and makes recommended improvements to contract manager or director.
• Understands Payer Policies and administrative guides and how it might impact the contract at hand.
• Recommends corrections, changes and any language opportunities in documents to leadership.
• Assists Payer Strategy Relations leadership with developing and updating project plan documents, meeting minutes and action item follow up related to National Payers renewals and planning.
• Ensures all amendments, letters of agreement (LOA), memorandum of understanding (MOU) and other contract documents are signed by the appropriate parties and provides the fully executed contract documents to the Contract Administration team.
• Ensures contract documents include rate escalators and obtains updated rate tables fee schedules and all contracting materials are stored according to PSR and/or Legal Policies, and ensures information is made available to or disseminated to key stakeholders of the negotiation process.
• Coordinates with other Payer Strategy Relations team members to facilitate credentialing and re-credentialing of CSH entities.

Qualifications
• High school diploma
• Three (3) years support of contract negotiation experience in a healthcare related field
• Payer or Provider experience

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