Quartz is seeking a healthcare reimbursement expert to join our organization as a Provider Contracting Strategist. This critical role will bring a deep understanding of the interdependencies between health plan and provider reimbursement strategies and rely on sound financial analysis to advise upon appropriate contractual terms that support both financial performance and high-quality patient care.
This role is ideal for a subject matter expert who can influence and advise at an enterprise-wide level using a financial, data-driven approach.
Benefits:
Work in a collaborative, provider-aligned environment, serving as a liaison focused on building strong partnerships and long-term value for health plan and provider stakeholders
Serve as a strategic advisor, influencing contracting decisions that directly impact financial outcomes and patient care
Starting salary based upon skills and experience: $78,000 to $98,500 annually plus robust total rewards package
Responsibilities:
Evaluate and assess provider network contracts for new and existing provider agreements, ensuring mutually beneficial terms that are aligned with current national and local competitive landscape and practices
Identify outliers and opportunities for improvement in new and existing provider agreements
Perform financial analysis, fee schedule generation, and analytics in accordance with internal modeling and best practice
Assist with drafting, reviewing and negotiating a wide range of provider contracts including value-based contracts and alternate payment methodologies
Assist in designing and refining provider networks based on clinical information, quality of care, and financial alignment
Advise internal stakeholders on contractual rights, obligations, risks and opportunities, driving continuous improvement and ensuring alignment with company policies and compliance requirements
Qualifications:
Bachelor’s degree with 2 years of experience with provider reimbursement methodologies, provider contractual terms, or related field using financial analysis, including construction of financial models and reports
Or
Associate’s degree with 5 years of experience with provider reimbursement methodologies, provider contractual terms, or related field using financial analysis, including construction of financial models and reports
Or
High School equivalency with 8 years of experience with provider reimbursement methodologies, provider contractual terms, or related field using financial analysis, including construction of financial models and reports
Provider reimbursement expertise across a variety of providers, including academic medical centers, acute care hospitals, community hospitals, ambulatory surgery centers, and / or critical access hospitals
Thorough understanding of fully insured and commercial payment methodologies
Advanced analytical capabilities, with the ability to use tools such as Excel, Business Objects, etc. to deliver and support data-driven recommendations
Enterprise-level thinking: understanding cross-departmental needs and challenges, with the ability to influence decisions and problem solve toward a common goal
Intellectual curiosity to stay abreast of latest reimbursement methodologies and ability to understand whether they are appropriate for Quartz.
Preferred licenses: Certified Billing and Coding Specialist (CBCS), Certified Coding Specialist (CCS), Certified Professional Coder (CPC)
Quartz offers an excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. To support a safe work environment, all employment offers are contingent upon successful completion of a pre-employment criminal background check.
Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified person with disability.
Numbers & Facts
Location
Wisconsin
Job Type
Full-time
Salary
$78,000–$98,500 Per Year
Skills
Acute Careunmatched
Analysis Skillsunmatched
Best Practicesunmatched
Billingunmatched
Certified Coding Specialist (CCS)unmatched
Certified Professional Coder (CPC)unmatched
Clinical Informationunmatched
Constructionunmatched
Continuous Improvementunmatched
Contract Analysisunmatched
Contract Requirementsunmatched
Corporate Policiesunmatched
Fee Scheduleunmatched
Financial Analysisunmatched
Financial Modelingunmatched
Financial Reportingunmatched
Health Planunmatched
Healthcare Providersunmatched
Healthcare Reimbursementunmatched
Hospitalunmatched
Negotiation Skillsunmatched
Network Performance/Analysisunmatched
Patient Careunmatched
Problem Solving Skillsunmatched
Process Improvementunmatched
Provider Contractingunmatched
Quality of Careunmatched
Regulatory Complianceunmatched
Reimbursementunmatched
SAP BusinessObjectsunmatched
Secondary Schoolunmatched
Team Playerunmatched
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