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Network Contracting MH Leader, Professional Relations

Tarrytown Office, Tarrytown, New York, United States of America Req #236
Tuesday, August 13, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

 Status: Full-time, Exempt: Yes

 

Manages hospital/health system relationships including negotiations of rates, reimbursement methodologies, issue resolution, and contract language. Responsible for maintaining a positive professional working relationship between MVP and hospitals/health systems. Uses data on cost, utilization and other data trends as part of the negotiation process. Uses Medicare, Medicaid and MVP proprietary reimbursement methodologies to analyze and negotiate new and renewed agreements in a manner needed to support MVP's premiums. Participates in the MVP premium development process, as needed. Coordinates with other internal Departments regarding (1) resolving and preventing hospital/health system problems and issues, (2) formulation of MVP policies and procedures, and (3) implementing new and revised hospital/health system agreements and rates. Serves as technical lead for hospital/health system reimbursement issues related to products and services. Assists in development and maintenance of a contracts database. Ensures that Management is kept informed of proposals and/or material changes with hospitals/health systems that may or will affect the organization. Works in a cooperative and coordinated manner with MVP's regional offices headquarters. Manages the activities of the Contracts team. Travels as needed. Performs others duties as assigned

POSITION QUALIFICATIONS

Minimum Education: BS degree. Demonstrated knowledge of acquired statistical methods. Master's degree preferred.

Minimum Experience: Minimum of 3-5 years healthcare reimbursement management experience.

Required Skills: • Good understanding of current reimbursement methodologies of Medicaid, Medicare and other commercial insurers for hospitals. • Excellent interpersonal skills to develop and maintain positive relationships. • Detail-oriented with ability to maintain high level of accuracy while working on multiple projects within time constraints. • Ability to work independently and possess good judgment skills. • Excellent oral and written communication skills. Preferred Skills: • Previous experience in contractual negotiations. #Zip
 

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Provider Relations
  • Pay Type Salary
  • Tarrytown Office, Tarrytown, New York, United States of America