Contracting Specialist

VNS Health; New York (NY); On-site; USD 70,000 - 88,000; Full time

Benefits offered by this job

Referral bonus opportunities

Generous PTO 30 days + 9 holidays

Health insurance for you and yourLoved

Employer-matched 401k retirement plan

Wellness programs

Pre-tax FSAs for healthcare and depend

Tuition reimbursement

Professional growth and CEU credits

Job summary

VNS Health in New York is seeking a contracts professional to review and negotiate provider agreements, supporting the network across our health plans. This role focuses on expanding and maintaining the provider network within established guidelines and working with various internal teams to align contracting with product offerings.

You will ensure contracts comply with state and federal guidelines, coordinate implementation, and contribute to reimbursement practices and growth initiatives.

Qualifications

• Minimum 3 years of related experience in health care or related field; total 5+ years in a professional environment.
• Experience working with network service providers and negotiating/administering contracts.
• Familiar with contract language and rate negotiations with one or more provider types (physicians, SNF, DME, homecare, hospitals).

Responsibilities

• Negotiate contractual terms, services and rates of reimbursement with providers to expand and maintain the network within guidelines.
• Negotiate single case and letters of agreement for out-of-network providers.
• Review contracts to ensure regulatory and financial compliance.
• Ensure all contract templates comply with State and Federal guidelines.
• Manage implementation of key agreements.
• Coordinate with other VNS Health units to leverage resources in contracting, network performance and reimbursement.
• Stay abreast of industry trends and regulatory changes; inform management and recommend actions.
• Participate in special projects and perform other duties as assigned.

Skills

Contract negotiations

Provider contracting

Regulatory compliance

Network planning

Education

Associate's Degree in related field

Job description

Overview

Reviews contracts and facilitates contracting with the VNS Health Plans provider network as it pertains to all provider types and for all VNS Health offered products. Negotiates and coordinates the implementation of provider agreements. Supports the strategic alignment of the network to align the company's various product offerings. Works under general supervision.

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched 401k retirement saving program and opportunity for both pre- and post-tax contributions
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent careand commuter transit program
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth, career advancementand CEU credits

What You Will Do

• Negotiates contractual terms, services and rates of reimbursement with providers to foster network expansion and maintenance within established guidelines.
• Negotiates single case and letter of agreements for out of network providers.
• Reviews contracts to ensure regulatory and financial compliance.
• Ensures that all contract templates are compliant with State and Federal guidelines.
• Manages the implementation of key agreements.
• Works with other VNS Health business units to coordinate efforts and leverage resources in provider contracting, network performance, reimbursement and other related matters.
• Keeps abreast of current industry trends, governing regulations, reimbursement practices and market players. Keeps VNS Health
• Plans management informed of trends/changes and makes recommendations based on this information.
• Participates in special projects and performs other duties as assigned.

Qualifications

Education:

• Associate's Degree in related field, or an equivalent combination of relevant education and experience required

Work Experience:

• Minimum three years of related experience in health care or related field, with a total of 5 or more years in a professional working environment required
• Experience working with network service providers and negotiating/administering contracts required
• Must be familiar with and have participated in contract language and rate negotiations with one or more of the following provider types; physicians and physician groups, SNF, DME, homecare, hospitals. required

Pay Range

USD $70,200.00 - USD $87,700.00 /Yr.

About Us

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We're one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.