The successful individual is part of a strategic and dynamic team responsible for successfully negotiating complex contracts with healthcare systems, large medical groups, hospitals, ancillary providers and individual practitioners for CDPHP’s Commercial, Medicare and Medicaid lines of business within corporate parameters and strategic goals. The incumbent will negotiate independently in order to maximize internal and external stakeholder relationships that improve strategic business development opportunities with those providers.
- Bachelor's degree required; preferably in healthcare, business, finance or related field. 5 years related experience in health care contract rate and methodology negotiations may be substituted for degree.
- Master’s degree preferred.
- Minimum 3-5 years experience in progressive health care relationship, contracting or reimbursement models in Commercial, Medicaid, or Medicare products.
- Experience with state and federal regulations and reimbursement methodologies and rates required.
- Comprehensive negotiation skills across multiple lines of managed care business with a demonstrated ability obtain desired contractual outcomes on time and within budgeted trends.
- Thorough knowledge and understanding of current quality benchmarks and reimbursement methodology trends in health care delivery across Commercial, Medicare and Medicaid product lines.
- Must possess thorough knowledge of contracting structures and payment methodologies.
- Demonstrate a thorough and detailed understanding of state and federal regulatory contract and network requirements.
- Ability to adapt to regional travel.
Salary Grade: 16