AdventHealth University

Senior Contracting Negotiator Managed Care

AdventHealth University$66K — $123K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in healthcare or related field required; Master's preferred.
  • 5+ years in contract negotiations or administration experience required.
  • 7+ years in healthcare or insurance required.
  • Direct experience with managed care contract negotiation, administration, or implementation required.
  • Strong research and analytical skills for interpreting contract performance information.

Responsibilities

  • Make strategic recommendations to advance AdventHealth initiatives.
  • Manage tasks to meet timetables and milestones aligned with strategic goals.
  • Communicate effectively with coworkers, leadership, and external business partners.
  • Develop contract language and negotiation strategies to enhance performance standards.
  • Negotiate contracts with top-tier health plans to align with operational goals.
  • Lead or contribute to meetings as the primary liaison for the Managed Care department.
  • Facilitate successful contract negotiation through thorough preparation and research.

Benefits

  • Medical, Dental, Vision, Life, and Disability Insurance from Day One.
  • Paid Time Off from Day One.
  • 403-B Retirement Plan.
  • 4 Weeks 100% Paid Parental Leave.
  • Career Development resources available.
  • Whole Person Well-being resources included.
  • Mental Health Resources and Support offered.
  • Pet Benefits provided.
Full Job Description
All the benefits and perks you need for you and your family:

  • Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
  • Paid Time Off from Day One
  • 403-B Retirement Plan
  • 4 Weeks 100% Paid Parental Leave
  • Career Development
  • Whole Person Well-being Resources
  • Mental Health Resources and Support
  • Pet Benefits


Schedule:

Full time

Shift:

Day (United States of America)

Address:

2600 LUCIEN WAY

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Effectively makes strategic recommendations to AdventHealth provider business units and senior leadership to advance AdventHealth initiatives by evaluating new managed care opportunities related to identified health plan strategies (e.g. strategic business decisions, publications, behavioral trends, new product lines, benefit design, etc.) to appropriately respond to perceived healthcare market changes. Manages tasks to completion by developing timetables, milestones, and deadlines with the help of senior leadership to ensure the timely adherence to AdventHealth strategic goals. Effectively communicates with coworkers, leadership, AdventHealth as well as outside business unit leaders, and health plans through verbal and written messages establishing a clear, professional, and courteous position on behalf of AdventHealth. Refines ongoing managed care processes by developing information and documents such as contract language and negotiation strategies for the purpose of enhancing performance standards in the Managed Care department. Represents AdventHealth as lead negotiator for assigned top-tier and mid-level tier managed care health plans in facilitating contract negotiations with AdventHealth business divisions to further AdventHealth strategic, tactical, and operational goals. Assumes the role of a subject matter expert during contract negotiations by displaying proficiency and distinction related to managed care and contract negotiation topics with the intention of maintaining strategic alignment with contracted health plans. Seeks resolution to managed care issues by collecting and interpreting contract performance information (e.g. claims volumes, quality and efficiency reports, participation gap analysis, accounts receivable data, etc.) to preserve the integrity of those contracts. Acts as a primary liaison for the AdventHealth Managed Care department by leading or contributing to meetings and projects in service of AdventHealth strategic initiatives. Ensures the timely start of contract negotiation activities by ensuring that all necessary information relative to achieving successful negotiation is prepared and ready by performing research and coordinating with other Managed Care or AdventHealth departmental leaders and making recommendations as needed. Accepts responsibility for the overall contracting process by coordinating with other Managed Care teams and outside business units as applicable to identify contract implementation elements and opportunities. Exhibits research proficiency using applicable reports (e.g. financial statements, impact analyses, database systems, etc.) to effectively lead in contract negotiation and issue resolution. Assumes responsibility as a managed care liaison to assigned AdventHealth providers by leading or contributing as needed to contracting strategy development and implementation for the purposes of advancing the initiatives of those providers within the overall scope of AdventHealth managed care strategy. Other duties as assigned.

Schedule/Shift: Full-Time M/W/Th in office in Maitland, FL. Open to remote if not located within a 55-mile radius of office location.

Knowledge, Skills, and Abilities:
  • Understands the basic functions of a large integrated healthcare system.
  • Understands key elements of a contract as well as negotiation practices and processes
  • Can develop, implement, and execute research plans
  • Strong organizational skills
  • Self-motivated with the flexibility to multitask and restructure priorities in a fast-paced environment
  • Professional attitude and conduct
  • Typing: 35 wpm
  • Word processing, spreadsheet, and database proficiency
  • Proficiency with email, computer calendar, and web-based meetings and resources
  • Excellent communication skills, both verbal and written

Education:
  • Bachelor's [Required]
  • Master's [Preferred]

Field of Study:
  • Bachelor's in healthcare or related field Required
  • Master's in healthcare or related field Preferred

Work Experience:
  • 5+ training or experience in contract negotiations and/or contract administration and implementation [Required]
  • 7+ experience in healthcare or insurance [Required]
  • Direct experience with managed care contract negotiation, administration, or implementation. [Required]
  • Experience working with multi-hospital integrated delivery healthcare system. [Preferred]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$66,170.74 - $123,073.07

About AdventHealth University

AdventHealth University is a private university in Orlando, Florida. It was founded in 1992 and is affiliated with the Seventh-day Adventist Church. The university offers undergraduate and graduate degree programs in various fields including nursing, radiography, and sonography. AdventHealth University is accredited by the Southern Association of Colleges and Schools Commission on Colleges.
Learn more about AdventHealth University
Size
1,000 employees
Industry

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