Senior Contracting Negotiator Managed Care

adventhealth; Biñan; Hybrid; PHP 4,136,000 - 7,692,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth in Maitland, Florida, is seeking a Senior Manager for managed care contracting. You will lead negotiations with top-tier health plans, coordinate cross-functional teams, and drive strategic initiatives to align contracts with AdventHealth goals.

Ideal candidates bring 7+ years in healthcare contracting, strong negotiation skills, and the ability to manage complex projects within a large integrated system.

Qualifications

• Bachelor's degree in healthcare or related field required.
• Master's degree in healthcare or related field preferred.
• 5+ years in contract negotiations or contract administration.
• 7+ years in healthcare or insurance.
• Direct experience with managed care contract negotiation, administration, or implementation.
• Experience with multi-hospital integrated delivery system preferred.

Responsibilities

• Advise AdventHealth on managed care strategy and contracting.
• Lead contract negotiation with health plans and providers.
• Develop timetables, milestones, and deadlines with senior leadership.
• Coordinate with managed care teams for contract implementation.
• Represent AdventHealth in negotiations with external partners.
• Provide expertise in contract performance analysis and issue resolution.

Skills

Contract negotiations

Negotiation practices

Research planning

Organization

Self-motivated

Professional attitude

Typing 35 wpm

MS Office

Email/calendar

Communication skills

Education

Bachelor's degree

Master's degree

Bachelor's in healthcare

Master's in healthcare

Tools

Contract negotiations software

CRM/ERP systems

Job description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

2600 LUCIEN WAY

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Effectively makes strategic recommendations to AdventHealth provider business units and senior leadership to advance AdventHealth initiatives by evaluating new managed care opportunities related to identified health plan strategies (e.g. strategic business decisions, publications, behavioral trends, new product lines, benefit design, etc.) to appropriately respond to perceived healthcare market changes. Manages tasks to completion by developing timetables, milestones, and deadlines with the help of senior leadership to ensure the timely adherence to AdventHealth strategic goals. Effectively communicates with coworkers, leadership, AdventHealth as well as outside business unit leaders, and health plans through verbal and written messages establishing a clear, professional, and courteous position on behalf of AdventHealth. Refines ongoing managed care processes by developing information and documents such as contract language and negotiation strategies for the purpose of enhancing performance standards in the Managed Care department. Represents AdventHealth as lead negotiator for assigned top-tier and mid-level tier managed care health plans in facilitating contract negotiations with AdventHealth business divisions to further AdventHealth strategic, tactical, and operational goals. Assumes the role of a subject matter expert during contract negotiations by displaying proficiency and distinction related to managed care and contract negotiation topics with the intention of maintaining strategic alignment with contracted health plans. Seeks resolution to managed care issues by collecting and interpreting contract performance information (e.g. claims volumes, quality and efficiency reports, participation gap analysis, accounts receivable data, etc.) to preserve the integrity of those contracts. Acts as a primary liaison for the AdventHealth Managed Care department by leading or contributing to meetings and projects in service of AdventHealth strategic initiatives. Ensures the timely start of contract negotiation activities by ensuring that all necessary information relative to achieving successful negotiation is prepared and ready by performing research and coordinating with other Managed Care or AdventHealth departmental leaders and making recommendations as needed. Accepts responsibility for the overall contracting process by coordinating with other Managed Care teams and outside business units as applicable to identify contract implementation elements and opportunities. Exhibits research proficiency using applicable reports (e.g. financial statements, impact analyses, database systems, etc.) to effectively lead in contract negotiation and issue resolution. Assumes responsibility as a managed care liaison to assigned AdventHealth providers by leading or contributing as needed to contracting strategy development and implementation for the purposes of advancing the initiatives of those providers within the overall scope of AdventHealth managed care strategy. Other duties as assigned.

Schedule/Shift: Full-Time M/W/Th in office in Maitland, FL. Open to remote if not located within a 55-mile radius of office location.

Knowledge, Skills, and Abilities:

• Understands the basic functions of a large integrated healthcare system.
• Understands key elements of a contract as well as negotiation practices and processes
• Can develop, implement, and execute research plans
• Strong organizational skills
• Self-motivated with the flexibility to multitask and restructure priorities in a fast-paced environment
• Professional attitude and conduct
• Typing: 35 wpm
• Word processing, spreadsheet, and database proficiency
• Proficiency with email, computer calendar, and web-based meetings and resources
• Excellent communication skills, both verbal and written

Education:

• Bachelor's [Required]
• Master's [Preferred]

Field of Study:

• Bachelor's in healthcare or related field Required
• Master's in healthcare or related field Preferred

Work Experience:

• 5+ training or experience in contract negotiations and/or contract administration and implementation [Required]
• 7+ experience in healthcare or insurance [Required]
• Direct experience with managed care contract negotiation, administration, or implementation. [Required]
• Experience working with multi-hospital integrated delivery healthcare system. [Preferred]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$66,170.74 - $123,073.07

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.