Building Location
Business Service Center
Department
48470 Pop Health Finance & Analytics
Job Description:
The Senior Payer Contracting Negotiator will be responsible for negotiating fees for services and value-based payer contracts for the full suite of services offered within Essentia Health. The negotiations will include language and reimbursement terms within defined parameters and processes to ensure Essentia Health’s success within the agreement. Knowledgeable in reimbursement and methodologies, coding, claim edits, and health plan business practices.
Education Qualifications:
Key Responsibility:
- Negotiates, review, analyzes contracts, and handles dispute resolution and settlement negotiations with payers
- Interprets contractual requirements to include federal and state regulations
- Manages contract performance in support of financial goals and strategies
- Collaborates cross-functionally to contribute to developing negotiation and reimbursement modeling activities
- Responsible for identifying and making recommendations to manage cost issues and supporting cost-saving initiatives
- Ensures resolution of escalated issues related to contract interpretation accuracy of payer contract
Educational Requirements:
- Bachelor’s degree required or equivalent work experience
Required Qualifications:
- Possess minimum of Five years of experience in managed care contracting and negotiations within a health plan or health system
- Strong interpersonal, communication, critical thinking, and problem resolution skills
- Intermediate skills in Microsoft word and Excel
- General knowledge of contract management system
FTE
1
Shift Rotation
FTE Flex Days (United States of America)
Shift Start Time
8:00 AM
Shift End Time
5:00 PM
Pay Range
$75421 – $113131 / year
The approximate base compensation range is posted, but the actual offer will reflect our total compensation and benefits package. The offer will be determined by a number of factors including the selected candidate’s experience, knowledge, skills, abilities, FTE, as well as internal equity among our team.
Weekends
none
Effective December 1, 2019: Job offers are contingent upon successful completion of a post-offer assessment, including a urine drug screen, immunization review, proof of required vaccinations, and background check. Essentia Health is committed to maintaining a work environment free from the influence of illegal drugs and alcohol.
Essentia Health EEO:
Essentia Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, sexual identity, national origin, disability, protected veteran status, or any other characteristic protected by law.