Network Contracting MH Leader, Professional Relations
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
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
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- Job Family Provider Relations
- Pay Type Salary
- Tarrytown Office, Tarrytown, New York, United States of America