Contracting Specialist, Managed Care

Overview

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Contracting Specialist, Managed Care supports initiatives for HMH Physicians, Physician Related Entities, Urgent Care and Facility, Pay for Performance (P4P) and Professional Behavioral Health Services during system and new entities negotiations in accordance with Hackensack Meridian Health's (HMH) established rate and language parameters under the senior department leadership direction. Will be responsible for addressing operational, financial and services issues and facilitate contract implementation within key operational areas throughout the organization for assigned payers and HMH entities.

Responsibilities

A day in the life of a Contracting Specialist, Managed Care at Hackensack Meridian Health includes:

• Work under the direction of Managed Care Leadership to support the Managed Care Team during system and new entities negotiations in accordance with HMH's established rate and language requirements.
• Negotiation of contractual language and redline of associated agreements/amendments in compliance with HMH legal and business requirements for assigned payers.
• Responsible for working with internal and external partners on credentialing applications and re-credentialing for assigned payers.
• Address operational, financial and service issues and facilitate contractual implementation with key operational areas throughout the organization for assigned payers and HMH entities.
• Assist with education of assigned entities on requirements of managed care agreements/amendments.
• Project management of assigned projects within departmental and organizational timelines and established parameters
• Procurement of internal data for assigned projects.
• Assist with reviewing and resolving contractual and operational issues with Managed Care companies.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's Degree in Finance or Health related field.
• Minimum of 3 or more years of experience in Hospital, Facility, Ancillary, Physician Provider Contracting and operational experience, including a well-rounded full and comprehensive understanding of Managed Care contractual language, regulations and editing/redlining of Agreements/Amendments.
• Ability to negotiate HMH required language parameters with payers.
• Ability to work independently with minimal supervision.
• Work well under pressure, multitasker and managed to department and organizational timelines
• Excellent analytics and problem solving skills.
• Utilize tack and sensitivity in communicating effectively with internal and external customers.
• Excellent written and verbal communication skills.
• Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

Starting Minimum Rate

Minimum rate of $14,630.72 Annually

Job Posting Disclosure

HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. Experience: Years of relevant work experience. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. Skills: Demonstrated proficiency in relevant skills and competencies. Geographic Location: Cost of living and market rates for the specific location. Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.