JOB SUMMARY: This position is responsible for management and negotiations of healthcare provider contracts.
Negotiates, re-negotiates and executes Hospital and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals.
Develops strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network growth, and/or efficiency targets.
Fundamental components of this position:
• Analysis of profitability of provider contracts, sustainability, and member access to existing network of participating providers.
• Development of strategies to improve member access to participating providers.
• Development of strategies, contracts, and rate methodologies to improve profitability.
• Negotiation of provider agreements with provider management staff, including senior level administration.
• Maintaining a strong working relationship with the provider community, developing and cultivating an atmosphere of mutual trust.
• Helping providers to get their issues resolved as needed.
Performs other duties as assigned.
• Knowledge of Alaska Tribal Health System, ANTHC, and Alaska Native culture(s) and politics.
• Knowledge of the healthcare industry.
• Knowledge of multiple reimbursement methodologies used in healthcare provider contracts.
• Skill in effectively managing priorities and multi-tasking in a fast-paced work environment.
• Skill in maintaining a high level of quality while working on aggressive time frames.
• Skill in working productively with internal professionals in multiple departments, including Legal, Revenue Cycle, Compliance, and Executive Leadership.
• Skill in both written and oral communication.
• Skill in effectively communicating with healthcare providers, including administrators and clinicians.
• Skill in dealing with multiple healthcare provider types, including hospitals, physicians, ancillary providers, and vendors.
• Skill in negotiating provider contract language.
• Skill in negotiating contract terms and rates with varied provider entities.
• Skill in establishing and maintaining cooperative working relationships with others.
• Skill in operating a personal computer utilizing a variety of applications.
MINIMUM EDUCATION QUALIFICATION
A Bachelor’s Degree in Accounting, Finance, or related discipline.
MINIMUM EXPERIENCE QUALIFICATION
Non-supervisory - Six (6) years professional work experience in healthcare contract negotiations.
MINIMUM CERTIFICATION QUALIFICATION
PREFERRED EDUCATION QUALIFICATION
• A Master’s Degree in Business Administration preferred.
PREFERRED EXPERIENCE QUALIFICATION
• Experience with Paid for Performance, Accountable Care Act, Valuebase Solutions, IPH, HPO, Hospital Contracting highly desired.
• Hospital Contract Negotiation experience highly preferred.
• Healthcare Network development/management experience or comparable healthcare background.
PREFERRED CERTIFICATION QUALIFICATION
The following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job:
• Must be able to lift approximately 20 pounds.
• ANMC is not a latex free environment. Therefore, some latex exposure can be expected.