Provider Contracting Strategist

Quartz isseekingahealthcare reimbursement expert to join our organization as aProvider ContractingStrategist.This critical role willbringadeepunderstandingof the interdependencies between health plan and provider reimbursement strategiesand rely on sound financial analysistoadvise uponappropriate contractualtermsthatsupportboth financial performance and high-quality patient care.

This role is ideal fora subject matter expert who can influence and advise atanenterprise-widelevelusing a financial, data-driven approach.

Benefits:

• Work in a collaborative, provider-aligned environment, serving as a liaison focused on building strong partnerships and long-term value for health plan and provider stakeholders
• Serve as a strategic advisor, influencing contracting decisions that directly impact financial outcomes and patient care
• Starting salary based upon skills and experience: $78,000 to $98,500 annually plus robust total rewards package

• Evaluate and assess provider network contractsfor new and existing provider agreements, ensuring mutually beneficial terms that are aligned with current national and local competitive landscape and practices
  • Identify outliers and opportunities for improvement in new and existing provider agreements
  • Perform financial analysis, fee schedule generation, and analytics in accordance with internal modeling and best practice
• Assist with drafting, reviewing and negotiating a wide range of provider contracts including value-based contracts and alternate payment methodologies
• Assist in designing and refining provider networks based on clinical information, quality of care, and financial alignment
• Advise internal stakeholders on contractual rights, obligations, risks and opportunities, driving continuous improvement and ensuring alignment with company policies and compliance requirements

• Bachelors degree with 2 years of experience with provider reimbursement methodologies, provider contractual terms, or related field using financial analysis, including construction of financial models and reports

Or

• Associates degree with 5years ofexperience with provider reimbursement methodologies, provider contractual terms, or related field using financial analysis, including construction of financial models and reports

Or

• High Schoolequivalencywith 8 years of experience with provider reimbursement methodologies, provider contractual terms, or related field using financial analysis, including construction of financial models and reports
• Provider reimbursement expertise across a variety of providers, including academic medical centers, acute care hospitals, community hospitals, ambulatory surgery centers, and / or critical access hospitals
• Thorough understanding of fully insured and commercial payment methodologies
• Advanced analytical capabilities, with the ability to use tools such as Excel, Business Objects, etc. to deliver and support data-driven recommendations
• Enterprise-level thinking: understanding cross-departmental needs and challenges, with the ability to influence decisions and problem solve toward a common goal
• Intellectualcuriosityto stay abreast of latest reimbursement methodologies and ability to understand whether they areappropriate forQuartz.
• Preferred licenses: Certified Billing and Coding Specialist (CBCS), Certified Coding Specialist (CCS), Certified Professional Coder (CPC)

Quartzoffersan excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. To support a safe work environment, all employment offers are contingent upon successful completion of a pre-employment criminal background check.