Are you a contracts coordination and negotiation guru? Do you have experience interfacing with large healthcare provider and physician groups? Do you pride yourself on building and nurturing relationships? If so, this Provider Contracts Administrator opportunity may be the role for you!

This hybrid role will be a blend of remote and in person work. Attendance at team meetings and visiting providers throughout the HAP member service area required.

GENERAL SUMMARY:

Responsible for provider contracting strategic initiatives that interface with all areas of the company and affect contractual arrangements with providers; manage and maintain operational and technical aspects of provider contracting; builds rates and reimbursement terms, manage configuration process for accurate reimbursement, maintain database related to reimbursement and rates, managed multiple projects simultaneously, and negotiates favorable contracts and builds integrity in contractual relationships within the scope of responsibility and subject matter expertise.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Manage rate configuration process for contractual relationships, including incentive and risk sharing models, with networks, IPAs, hospitals, hospital based physician groups and other providers to manage costs and improve quality, service, and access.
• Coordinates configuration for the contracting process by providing workflow documents, financial summaries, guiding principles, amendments, etc.
• Acts as subject matter expert for provider contracting operations and technical areas using Contract Management Software, FACETS, and other software.
• Manages Provider Contracting service agreements internally and externally to improve coordination and accuracy of the deliverables. Coordinates problem resolution and implements tactics to improve processes with other departments as necessary.
• Manages assigned projects related to Provider Contracting related to rates, reimbursements, audits, or special requests.
• Performs basic financial analysis of contract proposals and financial and utilization data to determine medical cost impact.
• Provide financial analysis and review of SOAs, financial statements, settlements and retro cap/eligibility issues. Facilitates resolution of financial issues between provider and financial area of the corporation as necessary and appropriate.
• Negotiates settlements and audit recoveries.
• Drafts template contracts consistent with regulatory and legal requirements and HAP contracting strategy. Secures necessary approvals from HAP’s Legal Department and the State of Michigan Office of Financial and Insurance Services.
• Effectively communicates contract terms to Information Systems for configuration.
• Represents Provider Contracting in multi-departmental settings/projects and leads projects as assigned.

HAP Pay Grade: 24