Contracting Specialist Senior

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Job Details

Requisition #:682395 Location:Johns Hopkins Health Plans, Hanover, MD 21076 Category:Finance Schedule:Day Shift Employment Type:Full Time

Job Summary:

Responsible for maintaining a primary responsibility for the development of provider networks that includes recruitment, negotiating complex contracts, contacting, and re-contracting of current provider network. The position is responsible for reviewing network adequacy and determining recruitment needs within all specialties, taking appropriate actions to recruit new providers to fill in gaps to meet accreditation standards and JHHP's strategic initiatives, and negotiating within the financial parameters to gain maximum cost efficiency and support JHHP's goals and strategic initiatives.

Negotiates complex contracts including Value based Contracts, Cost Reduction Related Contracts, "Risk" agreements, etc. Works in conjunction with analytics and the Finance team to develop financial models analyzing Value Based Contracts shared savings, Capitation, bundled pricing, and other reimbursement methodologies. Negotiates complex managed care contracts securing optimal reimbursement and driving high Quality outcomes.

Leads the implementation process to ensure all contracts are loaded into the provider maintenance Systems, reporting is implemented and contract is operational. Manages the post implementation Process of all assigned Complex Contracts. Manages and audits the loading and updates of pricing and reimbursement terms to ensure contract compliance and appropriate reimbursement. Actively works within Networks Management and is the JHHP Networks management representative to address any questions or concerns related to complex contracts.

Qualifications:

Education:

Bachelor's degree in business management or healthcare administration or related discipline required. Experience in lieu of education may be considered on a 2:1 basis. Master's degree preferred.

Work Experience:

Requires a minimum of five (5) years of experience in Contracting/Network Development in healthcare delivery program or insurance setting, experience in developing various reimbursement standards. May provide guidance or expertise to less experienced specialists. Experience should include: provider contracting, negotiating complex fee schedules, knowledge of managed care concepts and billing information systems. Value Based/Gain Share/Risk contracting experience preferred for Contracting Specialist III.

Salary Range: Minimum 34.41/hour - Maximum 56.82/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

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