Providence Senior Contract Manager in Renton, Washington
Providence St. Joseph Health is calling a Senior Contract Manager to our location in Renton, WA.
We are seeking a Senior Contract Manager who will lead, or participate as a team member, in significant negotiations with Payors for acceptable reimbursement terms and contract language for all entities within the continuum of care (i.e. hospitals, physician organizations, home health and hospice services) within the applicable PH&S Region (the Region) for the payors assigned to them. Payors include the revenue primarily associated with Commercial, Medicare Advantage, and managed Medicaid products. This includes development of negotiation complex strategy and securing acceptable terms, problem resolution, and obtaining applicable support of leaders within the Service Area, Regional, System, and/or with strategic partners, such as ACO’s and Joint Ventures.
This position is responsible for developing and maintaining positive working relationships between payors and the Providence organization. Acts as liaison between Health Plan’s, Physician Group’s, and other related payor organizations to ensure all aspects of payor relationships are managed effectively. Works with applicable leadership to respond to opportunities for improvement in contract terms, rates and structure. Communicates and educates applicable staff regarding key aspects of new and modified payor contracts and Health Insurance products.
Performs all duties in a manner which promotes team concept and reflects the Providence Health & Services mission and philosophy.
In this position you will have the following responsibilities:
Conduct complex negotiations for Providence with payors as assigned and complete contracting process in a timely manner in accordance with Providence contracting principles, organizational policies and procedures, and consistent with PH&S’s Mission.
Resolves intricate negotiation issues by using a variety of past negotiation and analytic experiences.
Manages complex and significant relationships for all assigned contracts and payor collaboration activities for both commercial and government products.
Maintain positive professional relationships with payor representatives at all times. Responsible for asking and answering questions concerning contractual agreements and resolving differences in understanding.
Develops reimbursement strategies to maintain effective payor relationships, working closely with Contract Compliance/Reimbursement Auditing, Contract Analytics, Revenue Cycle, and applicable leadership.
Responsible for contract negotiations for Providence affiliated facilities as assigned, including acute and sub-acute facilities, Behavioral Health and Chemical Dependency facilities, Physician services, Ancillary services, Home Health Services, and Hospice.
Communicates effectively with internal constituents on reimbursement strategies, mechanisms to improve payor compliance, and to communicate status and outcomes of negotiations.
Demonstrated seasoned working knowledge of payor contracts and understanding of implications of contract changes.
Responsible to negotiate contracts with a comprehensive network of ancillary providers on behalf of capitated or accountable care provider networks (as applicable).
Keeps current with market trends and industry news including communication to appropriate organization-wide audiences.
Coordinates the finalization with payors a Letter of Agreement/Memorandum of Understanding as needed.
Uses critical thinking skills to ensure that the negotiations result in outcomes that are both financially and operationally beneficial.
Assists with the development of revenue projections by payor for annual budgeting and long range plans.
Participates in hospital/medical group, ASC and staff committee meetings as required.
Maintains confidentiality of sensitive information at all times.
Mentors others in the department.
Other special projects and duties as assigned.
Required qualifications for this position include:
Bachelor’s degree or equivalent combination of education and/or work experience.
8 years of related healthcare experience in contract negotiations, financial management, or related field.
Preferred qualifications for this position include:
Bachelor’s degree in Business Administration, Healthcare Administration, Finance, Accounting.
About the department you will serve.
Providence Shared Services provides a variety of functional and system support services for our Providence family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Lead/Supervisor/Manager
Req ID: 278728