Job Title: Cost Containment Negotiator - HIVE

Status: Exempt

Why this role is important:

You’ll be part of a team that’s reshaping how provider networks evolve and how health care works better for millions. As a part of the negotiation team you’ll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting.

What you’ll do:

● Identify, negotiate, and manage high performing provider and vendor partnerships.

● Negotiate vendor or provider contracts and manage implementations and ongoing relationships.

● Perform market research and analysis as directed

● Initiate and lead meetings with health plans and corporate teams, including executive management, to review vendor and provider agreement performance data and scorecards, and partnership strategy

● Process agreements internally through the contract lifecycle and for records retention

● Analyze proposals effectively and provide summaries and recommendations to decision makers.

● Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives.

● Facilitate and oversee the provider set-up and contract configuration to ensure accurate claims adjudication

● Initiate contact and identify potential providers by geographic and specialty needs and update database

● Coordinate with internal departments and contracted providers to implement and maintain contract compliance

● Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.

● Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.

● Independently determine appropriate action to resolve inquiries and single case agreement requests.

● Identifies solutions to non-standard requests and problems

● Ability to work independently to accomplish objectives and meet deadlines

● Translates concepts into practice

● Provides explanations and information to others on difficult cases

● Acts as a resource for others with less experience

● Comply with HIPAA regulations and ensure confidentiality of calls, documents, and other sensitive information.

● Properly document activity and calls in the appropriate system.

● Maintain established performance standards (production, quality, and attendance).

What you’ll bring:

● Knowledge of Medicare reimbursement

● Familiarity with fee for Service Model

● Excellent communication skills, both verbal and written

● Needs to have knowledge of contractual legal terms and contract construction

● Someone who takes pride in contributing to the organization

● A positive attitude, always striving for excellence.

● Confident in contentious discussions, with the ability to pursue the desired outcome

● Comfortable in a fast pace environment enjoys doing work that requires frequent shifts in direction

● Enjoys collaborating with fellow team members

● The ability to work independently, without close supervision

● Exceptional communication skills via phone and email

● The ability to execute decisions quickly and confidently

● Proactive problem solver

You might also bring:

● Associate or bachelor’s Degree 

● 4 years of vendor and/or provider contract negotiations, contract analysis and/or modeling experience in health care or similar industry

● Experience negotiating contracts with successful outcomes and measurable financial results.

● Experience with presenting and communicating negotiation strategies and results at senior levels

● Organizational skills and ability to follow process through to completion with appropriate documentation

● Based on business needs, hours outside your normally scheduled shift may be required

● Monday-Friday 8:30am-5pm EST work week

● Compensation Range: $60,000 - $90,000