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Senior Contract Negotiator

Company Name:
CDPHP
The Senior Contract Negotiator is responsible for leading, successfully negotiating, and managing multiple contracts and product lines of business with healthcare systems, large medical groups, hospitals, and ancillary providers. As part of this process, they need to be familiar with CDPHP's Commercial, Medicare and Medicaid lines of business within corporate parameters and strategic goals across entire geographic markets. In addition, this individual will act as an experienced team leader to the contracting team and direct the negotiations, rate modeling, contracting, recruitment, development, implementation and ongoing monitoring of all levels of contractual relationships to maximize internal and external stakeholder relationships that improve business development opportunities with providers
_QUALIFICATIONS:_
Bachelor's degree required. 7 years relevant experience may be substituted for degree.
A minimum of 7 years managed care experience as lead negotiator on complex contract and rate modeling across all provider types.
Previous experience with new business process enterprise implementation and extensive experience with DRG, Per Diem and Case Rate contracting and multiple reimbursement models within the industry for Commercial, Medicare and Medicaid managed care lines of business necessary.
Strong, specific experience related directly to the position in managed care contracting and negotiations required.
Proven record of leading projects, financial analyses and problem solving utilizing proficiency with Microsoft Office Suite with experience in stand-alone contract modeling software strongly preferred.
Ability to lead, facilitate and implement contracting and negotiation projects for hospital, ancillaries and physicians.
Robust analytical, written and professional verbal skills required with an ability to obtain desired contractual outcomes on time and within budgeted trends.
Demonstrated ability to lead and train others on contracting methodologies and rates and data requests necessary.
Thorough knowledge and understanding of current quality benchmarks and reimbursement methodology trends in health care delivery across Commercial, Medicare and Medicaid product lines.
Ability to conceptualize analytical approaches, manipulate and analyze healthcare data and explain decisions to all levels of executive management.
Knowledge of healthcare providers' claims billing and coding systems, policies, procedures and processes.
Comprehensive long-range financial modeling on multiple complex reimbursement methodologies, and related negotiation skills.
Outstanding high-level negotiation skills with the ability to train and lead the team.
Excellent public relations, problem solving, human relations, and conflict resolution skills.
Ability to present professionally to and interact with external provider senior financial and operations management, physicians and business offices, with a demonstrated ability to manage and shift priorities to meet day-to-day operational needs.
In depth understanding of health care coding, state and federal regulations and reimbursement rates and methodologies and possess thorough knowledge of contracting structures and payment methodologies.
Excellent written and verbal communication skills.
Ability to adapt to regional travel.
Salary Grade: 17
Location :Albany, New York US
Facility :CDPHP, Inc
Category :Professionals - A
Department :Healthcare Network Strategy

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