Contract Specialist, Midwest

Job ID
2019-90457
Employment Type
Full Time
Department
Managed Care Contracting
Hours / Pay Period
80
Facility
Dignity Health System Office
Shift
Day
Standard Hours
Monday - Friday (8:00 AM - 5:00 PM)
Work Schedule
8 Hour
Location
NE-Omaha

Overview

Dignity Health, one of the nation’s largest health care systems, is a 21-state network of 9,000 physicians, 59,000 employees, and more than 400 care centers, including hospitals, urgent and occupational care, imaging centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved.  In FY15, Dignity Health provided $1.7 billion charitable care and services. For more information, please visit our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook.

Responsibilities

Job Summary: 

The Contract Specialist, Divisional Payers, Payer Strategy & Relationships (PSR) works closely with Divisional Payers, the Payer Relations Manager, Divisional Directors, National PSR team, and the PSR Analytics & Innovation team, to support the negotiation of terms and conditions for Managed Care payer contracts for facility, professional, and ancillary entities. Primary focus of contracting and negotiation support is to ensure the terms and conditions of the payer contract adhere to the CSH Standards and Guidelines, represent industry best practices for Fee for Service and value-based arrangements, and align with operational objectives.

 

Job Responsibilities: 

  1. Review contract proposals, language and rate sheets to ensure accuracy, completeness and in compliance with CommonSpirit Health standards and guidelines.
  2. Recommend corrections, changes and any language opportunities in documents to Director.
  3. Assist Director with updating project plan documents, meeting minutes and action item follow up related to Divisional Payers renewals and planning.
  4. Ensure that all amendments, letters of agreement (LOA), memorandum of understanding (MOU) and other contract documents are signed by the appropriate parties and provide the fully executed contract documents to the Contract Administration team.
  5. Coordinate with Division PSR teams as needed to facilitate credentialing and re-credentialing of CSH entities.
  6. Maintains complete and up to date inventory of all CSH hospitals/specialty hospitals to include demographic information, license, NPI, Tax ID information, etc.
  7. Assist in communicating and operationalizing contract terms, amendments, and policy terms.
  8. Maintain Divisional Payer knowledge base to include financial statements/reports, news articles and other information.
  9. Adhere to all established contracting guidelines. Contracting accountability for negotiation support include hospital, physician, and ancillary services.

 

Qualifications

Minimum Qualifications: 

  • Education - High school diploma required.  Bachelor’s Degree in related discipline or equivalent work experience.
  • Experience - One (1) to two (2) years negotiation, sales or experience in a healthcare related field is required.  Three (3) to five (5) years experience preferred.
  • Skills, Knowledge and Abilities - This position requires knowledge and experience in reimbursement, the financial aspects of contracting and managed care operations.
  • Additionally, effective negotiation skills, project management skills, excellent written and verbal communication skills and expertise and experience with PC applications (Excel/Word) are required. 

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