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

  EDUCATION/EXPERIENCE REQUIRED:

• Bachelor's Degree in Business or related field of study or at least six (6) years of related experience in lieu of education requirement.

• Master’s degree highly desirable.

• Minimum of two (2) years with health care plan.

• Minimum of three (3) years of experience with project management in a health care operations setting.

• At least two (2) years of experience with Plan or Provider finance or reimbursement, contract administration and operations, preferred.

• Knowledge Oracle, Facets, Cognos, NetworX, and related claims systems and similar software strongly preferred.

• Experience using workflow tool(s).

• Ability to initiate and coordinate multiple projects simultaneously.

• Understanding of legal and business principles in healthcare.

• Experience with regulatory authorities and Michigan Physician market preferred.

  PHYSICAL DEMANDS/WORKING CONDITIONS:

• Position will require a flexible schedule with periodic evening/weekend work.

• Position requires travel with own car.

Additional Information

• Organization: HAP (Health Alliance Plan)

• Department: Provider Contracting

• Shift: Day Job

• Union Code: Not Applicable

  Additional Details

  This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Partnering with nearly 2 million people on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout southeast and south central Michigan. With 33,000 valued team members, Henry Ford is also among Michigan’s largest and most diverse employers. Our superior care and discoveries are powered by nearly 6,000 physicians, researchers and advanced practice providers. Learn more athenryford.com.

Benefits

Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.