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Contract Specialist II

Company: Optum
Location: Tacoma
Posted on: November 22, 2020

Job Description:

JOB DESCRIPTIONContracting Specialist IIDepartment: Practice SupportStatus: Regular Full-time, FLSA ExemptLocation: Tacoma, WAReports to: Director of ContractingJOB SUMMARY In support of NPN's mission, vision, and strategic goals, the Contract Specialist II is responsible for the identification and negotiation of contracts with hospitals, skilled nursing facilities, physicians and ancillary providers in geographically diverse areas for both existing and developing provider networks.-- Ensure proper administration of the contracts through assessment of provider needs, coordination of contract documentation, and interfacing with MCA, Claims, Care Management, IMCS, and other departments.ESSENTIAL DUTIES & RESPONSIBILITIES

  • Consistently exhibits behavior and communication skills that demonstrate NPN's commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
  • Assesses and completes provider contracting needs for all provider operations.
  • Provides guidance to Contract Specialists, Contract Coordinators and/or other staff in the absence of Director, Provider Contracting.
  • Prepares supporting documentation, negotiates and implements contracts of hospitals, skilled nursing facilities, physicians and ancillary providers in geographically diverse areas for both existing and developing provider networks.
  • Coordinates the completion of provider pre-contractual activities including the submission of relevant provider contract documentation, completion of RFP and application information, financial analysis, RAT discussions, credentialing, etc.
  • Prepares and/or coordinates financial and utilization analyses to develop recommendations for compensation methodologies and amounts, including capitation.
  • Cultivates positive working relationships with network Medical Directors and other administrative staff.
  • Develops and maintains client relationships and ensures continuing client satisfaction.
  • Assists in constant analysis of contracting needs including the assessment of claims and utilization data to identify areas for new and re-negotiated contracts.
  • Responds to correspondence and other communication in a professional and timely manner.
  • Uses, protects, and discloses NPN patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Performs additional duties as assigned.KNOWLEDGE, SKILLS AND ABILITIES
    • Knowledge of provider contracting and reimbursement arrangements
    • Understanding of medical care delivery and financing arrangements
    • Exceptional interpersonal skills with ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives and other health plan staff.
    • Strong verbal and written communication skills
    • Proven contract negotiations skills
    • Knowledge of Microsoft applications (Excel, Word).
    • Ability to work independentlyMINIMUM QUALIFICATIONSEducation:
      • 1 or 2 years of post-high school education or a degree from a two-year college.
      • Bachelor's degree preferred.Experience:Minimum:
        • Over 1 years and up to and including 3 years of experience.Preferred:
          • 3 years of healthcare experience in contracting or management.EQUIPMENT USEDOffice equipment, computer, personal vehicleMENTAL & PHYSICAL DEMANDS/WORKING CONDITIONS
            • Mental Effort: Must be able to work effectively as a member of NPN team; work is detailed and complex with multiple competing priorities, deadlines and internal and external customers
            • Physical Requirements: Work is primarily in office environment requiring ability to see and hear and communicate as well as operate personal motor vehicle
              • Working Conditions: Work is performed both in an office setting and at clinic locations; noise level may be moderate or loud on occasion; work may be required outside normal business hoursThe job description does not constitute a written or implied contract of employment.-- NPN reserves the right to revise or change job duties and responsibilities as the need arises.--

Keywords: Optum, Tacoma , Contract Specialist II, Other , Tacoma, Washington

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