Contract Negotiator - REMOTE

Position Summary

The Contract Negotiator is responsible for managing the day-to-day responsibilities related to managed care contracting and payer/provider relations. This includes acting as the liaison between NSPC network practices and contracted health plans to disseminate information, research reimbursement and clinical policies, support provider credentialing and onboarding, and resolving claims and other payer issues. The Contract Negotiator works with the Director of Managed Care, Revenue Cycle Management, Finance and Operations Departments, Billing and Credentialing Departments, NSPC Ambulatory Surgical Centers and Physician Practice Groups throughout the country. The Negotiator will participate in managed care negotiations, contract management, and financial analyses related to our reimbursement strategy. The Negotiator maintains confidentiality of all information, including negotiated fee schedules. This position reports to the Director of Managed Care.

Job Duties

• Prepares and maintains contract summaries
• Updates key performance indicators
• Manages fee schedules and customized uploads to a secure member portal
• Coordinates timeline for contract renewals, fee schedules updates, rate rebasing
• Organizes contract issues logs
• Meets routinely with NSPC entities and health plans to resolve contracting/claims issues
• Maintains continuous communication to keep practices apprised of issue status and resolution
• Conducts analysis of contract rates to ensure competitive position in support of defensible pricing under transparency
• Supports contract negotiation efforts by revenue modeling & rate evaluation
• Collaborates with payers and NSPC ASCs and physician groups to define appropriate CPT codes and reimbursement rates for existing and new services

Knowledge, Skills, and Abilities

Knowledge of:

• MS Word, Excel (Advanced) and PowerPoint
• Insurance regulations and reimbursement policies
• Managed care contracting principles
• Financial modeling and analysis

Skilled at:

• Excellent interpersonal, communication, problem-solving, and organizational skills
• Detail oriented with accompanying ability to multi-task and prioritize
• Negotiating contracts

Ability to:

• Work independently, learn new systems and concepts, analyze data, identify errors & resolve problems in a timely manner

Requirements:

Minimum Education and Experience Required

Education (degree/type of degree).

• Minimum: Bachelor's degree preferred from accredited college or university or two years experience in lieu of degree

Experience (minimum years & type of experience).

• Minimum: Two years of managed care contracting and/or provider relations experience
• Preferred: Experience developing financial models and analyses