All jobs

Insurance Contract Administrator - Full Time- Remote/Hybrid

100% Remote Full-time Open now

To develop, maintain, implement and monitor contractual relationships with third party Insurance Payors on behalf of HFHS and its business units. PRINCIPAL DUTIES AND RESPONSIBILITIES : 1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units. 2. Independently evaluate and analyze contract proposals including completing initial proposal responses and reviewing / revising contract language and operational requirements. Reviews contracts with in house legal-council and works through contract revisions with Payors. 3. Routinely monitor current contracts for appropriate rate structure, contract terms and annual renewals and / or re-negotiations and compliance with industry standards and guidelines. 4. Monitor marketplace for new contracting opportunities and make recommendations of changes to enhance HFHS contract portfolio. 5. Coordinate implementation of Payor arrangements and provide ongoing education and support throughout HFHS. 6. Collect and communicate relevant contractual requirements and issues to internal customers such as Utilization Management, Finance, Patient Billing, Administration, Legal, etc. Information includes; payor relationships, operational requirements and contract terms. 7. Maintain comprehensive files of HFHS contractual relationships and update contract information in the contract database. 8. Maintain contract summaries on HFHS website (Henry). 9. Act as liaison between HFHS and Payors on contracting and operational issues, i.e. billing, utilization review, credentialing site visits, notification of site closures or new services. 10.Coordinate facility credentialing and re-credentialing. 11.Perform other duties as assigned. EDUCATION / EXPERIENCE REQUIRED : • Bachelors Degree in Business, Healthcare or related field. • Minimum of four years in the healthcare industry in a professional capacity. • Knowledge of managed care organizations and integrated health systems. • Previous contracting, provider relations and / or provider reimbursement experience. • Comprehensive project management abilities. • Excellent oral and written communication and presentation skills. • Excellent organizational skills and ability to manage multiple projects simultaneously. • Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers. • Strong negotiation skills. • Understanding of legal, business, and insurance operations principles. Proficient in Microsoft Word. PHYSICAL DEMANDS / WORKING CONDITIONS : • Normal office environment with minimal exposure to noise, dust, or extreme temperatures. LI-VD1 Additional Information Organization : Corporate Services Department : Managed Care Contracting Shift : Day Job Union Code : Not Applicable Apply Job!

You might also like

Accounting Manager - Non Profit (Hybrid Remote)

100% Remote Full-time

R-107071 Commercial Equipment Regional Sales Manager (Midwest)

100% Remote Full-time

Investment Banking - Private Equity Career Specialist

100% Remote Full-time

Senior Accountant/Full Charge Bookkeeper - Remote Working

100% Remote Full-time

Senior Accountant/Full Charge Bookkeeper - Remote Working

100% Remote Full-time

Clinical Trial Liaison (CTL), Neurology (Nationwide US)

100% Remote Full-time

Youth Worker/Direct Care - Heartland Boys Academy

100% Remote Full-time

Investment Analyst (Loan Ops) – Entry Level

100% Remote Full-time

Machine Learning Engineer - Contract to Hire

100% Remote Full-time

Principal AI Scientist - Payments Analytics Studio

100% Remote Full-time

Virtual App Tester – Review Writer (Entry Level, Work from Home) –

100% Remote Full-time

Service Representative II

100% Remote Full-time

RN Manager, Case Management – Amazon Store

100% Remote Full-time

Attorney - Employment Law / Class Action

100% Remote Full-time

Remote --- Automotive Sales & Service Representative

100% Remote Full-time

Call Center Agent- Remote After Training Full Time, 8:00am-4:30pm

100% Remote Full-time

Senior React Native Engineer

100% Remote Full-time

Experienced Live Chat Specialist/Virtual Assistant/Remote Technical Support Agent – Work From Home Opportunity at arenaflex

100% Remote Full-time

Presales & Solutions Leader – Technology as a Service (TaaS)

100% Remote Full-time

Senior Account Executive

100% Remote Full-time