Contract Representative II - Remote (AK, AZ, ID, FL, OR, TX, WA)

 

Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

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The Contract Representative II will be responsible for preparing, reviewing and revising contracts, use analytical tools and strong communication skills in negotiating challenging contract renewals, enter contracts into our contract management database, and contributing to corporate projects. Cultivate and maintain professional relationships with providers and practices in assigned portfolios.

This is a full-time remote position for candidates living or willing to relocate to the following States ONLY: AK, AZ, FL, ID, OR, TX, or WA.

Please follow the link below to apply to this position:

• https://j.brt.mv/jb.do?reqGK=27708724&refresh=true

Benefits:

• Medical, Dental, Pharmacy and vision coverage
• 401K
• FSA
• PTO and paid holidays

Schedule:

• PST schedule .

Required Skills, Experience & Education:

• Bachelor’s degree in Business, Finance, Health Care Administration or 2 years’ equivalent work experience in a related field.
• Minimum 3+ years’ experience negotiating contracts, specifically with ancillaries, facilities, specialty providers, and physician groups.
• Position requires a highly self-motivated person who is able to apply judgment in the prioritization of assignments, is organized and efficient in their approach to the work, and is able to work both independently and as a team member in achieving objectives.
• Demonstrated strong interpersonal communication skills, including strong business writing skills in a manner that promotes goodwill, is timely, efficient and accurate.
• Possess strong analytical, attention to detail, and problem-solving skills.
• Understanding of physician, hospital, and other provider contracts and reimbursement mechanisms.
• Ability to work with internal stakeholder departments to create a seamless and positive experience for the provider.
• Strong judgment and decision making skills with ability to develop and foster strong working relationships.
• Strong PC proficiency with Microsoft Office applications.
• Ability to maintain confidentiality and project a professional business presence and appearance.
• Ability to perform in a fast paced environment with competing priorities on a daily basis. Due to the demands placed on the Medical Provider Relations Department, the pace in the department is rapid and dynamic, sometimes causing project priorities to rapidly and significantly shift. The Contract Representative II must be flexible, adaptable, and able to meet deadlines under pressure.
• Ability to work well under pressure as well as with frequent interruptions and shifting priorities. Ability to function effectively in a complex, ambiguous, demanding, and rapidly changing environment.
• Ability to come in to work on time and on a daily basis, working the hours required to support the team and meet all goals and objectives.

Primary Functions :

• Develops strategic relationships with key providers, negotiating annual rate increases within set parameters and guidelines within an assigned portfolio and providing recommendations to leadership on the renewal.
• Handles complex contracts using problem solving skills to meet budget constraints, develops rapport with provider groups and/or hospitals as well as works with the Provider Analytics and Contract Pricing teams on solving complex rate methodologies within assigned portfolio.
• In collaboration with Provider Network Manager, develop a contracting approach and develop specialized expertise required to contract with new types of provider entities. This can occur when entering into a new ongoing contractual relationship or when negotiating Single Case Agreements.
• Support the implementation of Value-Based contracting models (VBC), capitation, Advanced Payment Models (APMs) and other population health initiatives.
• Assists in the periodic assessment of Moda’s network status and recommends strategies when new trends are identified.
• Conducts strategy development based on network analysis results.
• Assists in the new implementation and ongoing modification of Moda’s statewide, regional, and local network strategies.
• Utilize best practice policies and procedures, work guides or tools to provide improved department process workflows.
• Coordinate and participate in targeted provider meetings, including annual Provider Workshops, with Provider Relations Representatives in assigned portfolio.
• Represents Moda at meetings and events at which contracted Moda hospitals and key Moda providers will be attending.
• Provides ongoing support to team members.
• Performs other duties as assigned.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.

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