DaVita Contract Specialist in Las Vegas, Nevada

HealthCare Partners- NevadaContract SpecialistOVERALL JOB PURPOSE

The function of this position is to provide support to ongoing contracting support for Corporate initiatives, including supporting contracting to ensure an

appropriate network to respond to the service needs for HMO membership in a mixed model environment. The Contract Specialist must have knowledge of

contract structure, basic state and Federal requirements, and ability to execute and process a contract.

MINIMUM JOB QUALIFICATIONS AND REQUIREMENTS

Education:

  • Undergraduate degree in business or a health care related field preferred.

Experience:

  • Three to five years of Managed Care experience to include

  • contract language negotiation and financial negotiation of

  • physician, facility and ancillary contracts.

Knowledge, Skills and Abilities:

  • Attention to detail

  • Must posses excellent communication skills

  • Must possess a valid Nevada driver’s license

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

  • Responsible for quality and continuous improvement within the job scope.

  • Responsible for all actions/responsibilities as described in

    company controlled documentation for this position.
  • Contributes to and supports the corporation’s quality initiatives by planning, communicating, and encouraging team and individual contributions toward the corporation’s quality improvement

    efforts.
  • Obtains contract language, review comments and

  • recommendations and serves as a communication contract for contract language changes.

  • Coordinates involvement/approval of all contributing internal

    departments to structure design of contract.
  • Resolves pay or and provider problems throughout the contract negotiation process to ensure contract execution and

    implementation. Able to answer pertinent questions from provider.
  • Identifies and investigates new contract opportunities. Collects due diligence background information on potential contracting parties.

  • Monitors contracts, prioritizes work flow and initiates, and

    completes contract re-negotiations, renewals
  • Coordinates with network Operations team at all phases of

    negotiation to ensure that contracts can be implemented and administered in compliance with contract requirements.
  • Maintains excellent documentation of ongoing contract

    negotiation process including summaries of verbal discussion with internal and external parties.
  • Provides sufficient and timely follow-up to payers’ to

    progressively move contract negotiations activity towards closure and execution
  • Maintains a strong understanding of health care/payer/provider industry and Health Care strategy of the Health System, and

    utilizes knowledge on the job by reviewing literature relevant to the marketplace and managed care health needs, maintaining contracts with applicable payer organizations.

OTHER JOB DUTIES AND RESPONSIBILITIES

+ Performs other work related duties and responsibilities as

directed, assigned or requested.

+ Must be able to research information, analyze financial data,

exercise independent judgment, apply good organizational skills, and develop creative solutions to problems.
  • Must possess excellent communication skills.

  • Must be able to work in a collaborative fashion using negotiation skills.

  • Extensive knowledge of industry pricing mechanisms: Medicare based per diems. DRGs, global, case rates, and indexed fee

    schedules.
  • Ability to review financial data and manage financial information in order to identify and secure