Contract Specialist (Hybrid)

Overview:

Reviews contracts and facilitates contracting with the VNS Health Plans provider network as it pertains to all provider types and for all VNS Health offered products. Negotiates and coordinates the implementation of provider agreements. Supports the strategic alignment of the network to align the company's various product offerings. Works under general supervision.

 

Hybrid: 3 days in the office.

Responsibilities:

What We Provide

• Referral bonus opportunities    
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays  
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability    
• Employer-matched retirement saving funds  
• Personal and financial wellness programs   
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care    
• Generous tuition reimbursement for qualifying degrees  
• Opportunities for professional growth and career advancement   
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities    

 

What You Will Do

• Negotiates contractual terms, services and rates of reimbursement with providers to foster network expansion and maintenance within established guidelines.
• Negotiates single case and letter of agreements for out of network providers.
• Reviews contracts to ensure regulatory and financial compliance.
• Ensures that all contract templates are compliant with State and Federal guidelines.
• Manages the implementation of key agreements.
• Works with other VNS Health business units to coordinate efforts and leverage resources in provider contracting, network performance, reimbursement and other related matters.
• Keeps abreast of current industry trends, governing regulations, reimbursement practices and market players.
• Keeps VNS Health Plans management informed of trends/changes and makes recommendations based on this information.
• Participates in special projects and performs other duties as assigned.

 

Qualifications: Education:
Associate's Degree in related field, or an equivalent combination of relevant education and experience required

Work Experience:
Minimum three years of related experience in health care or related field, with a total of 5 or more years in a professional working environment requiredExperience working with network service providers and negotiating/administering contracts requiredMust be familiar with and have participated in contract language and rate negotiations with one or more of the following provider types; physicians and physician groups, SNF, DME, homecare, hospitals. required

Pay Range: USD $70,200.00 - USD $87,700.00 /Yr.