Senior Negotiator Managed Care Contracting

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Senior Negotiator, Managed Care Contracting
Duties: Negotiate and execute contracts with managed care payers and other third parties, within financial and language parameters established by the Managed Care Department leadership. Review, evaluate and document new and existing payer contract language compared to department language standards. Perform adhoc contract language review/analysis. Serve as internal resource for responding to payer contract language questions/requests. Work with financial analysts to prepare appropriate data/analysis for negotiations and for trended claim/operational issues. Manage planning process for contract negotiations and renewals, including assessment of historical performance and opportunities. Accomplish contracting of acquired/new facilities and practices. Facilitate resolution of contract-related claims and operational issues by proactively researching the issues and working with both internal and external customers. Communicate new and revised contract terms to internal customers. Research and provide analysis of regulatory issues. Negotiate and execute single case agreements as needed. Maintain database of key language terms by entity. Develop and maintain department tracking documents. Manage special projects as required. Other duties as assigned.

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