Job Details

ID #46069767
Estado Alaska
Ciudad Southeast alaska
Full-time
Salario USD TBD TBD
Fuente Highmark Health
Showed 2022-09-28
Fecha 2022-09-29
Fecha tope 2022-11-27
Categoría Etcétera
Crear un currículum vítae

Provider Contracting Consultant

Alaska, Southeast alaska, 99801 Southeast alaska USA

Vacancy caducado!

Company :Highmark Inc.Job Description :JOB SUMMARYThis position works within the Provider Contracting department and is the primary contact for ancillary and small hospital negotiations. The incumbent is responsible for completion of annual provider contracting activities and ongoing contract management activities. Primarily focused externally (negotiations, etc.) this role also acts a SME for internal projects, etc. at the direction of their management.ESSENTIAL RESPONSIBLITIESLead negotiations of assigned Ancillary and small hospital reimbursement and contractual terms. Development and execution of work plans and strategy for provider contracting initiatives.

Execute Highmark provider contracting strategy related to assigned ancillary reimbursement and contracting. Including standardization and unit cost trend.

Responsible for end-to-end provider contract administration and maintenance for assigned ancillary and hospital providers, supported by Sr. Provider Contract Analyst, etc.

Develop and maintain positive, effective relationships with assigned providers.

Support the management and development of Provider Contract Analysts.

Ensure compliance with contractual terms.

Other duties as assigned.

EDUCATIONRequiredBachelor's Degree

Substitutions6 years of healthcare experience in lieu of a bachelor's degree

PreferredNone

Licenses or CertificationsNone

EXPERIENCERequired5 - 7 years Health Insurance Industry

1 - 3 years Provider Contracting

PreferredNone

SKILLSNegotiation

Contract Management

Contracts Review

Written & Oral Presentation Skills

Problem Solving & Decision Making

Language (Other than English):NoneTravel Requirement:0% - 25%PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeOffice-basedTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteRarelyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsRarelyDisclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.EEO is The LawEqual Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migratedfiles/employers/posterscreenreaderoptimized.pdf )We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.For accommodation requests, please contact HR Services Online at [email protected] Consumer Privacy Act Employees, Contractors, and Applicants NoticeReq ID: J214962

Vacancy caducado!

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