Contracting Specialist II

The John Hopkins Health System; Hanover (MD); Remote; Full time

Job summary

Join a leading healthcare provider as a Contract Specialist II, where you'll develop and manage provider networks, negotiate contracts, and ensure compliance with reimbursement standards. This remote role offers a competitive salary and comprehensive benefits. Be part of a transformative healthcare team committed to equitable delivery.

Benefits

Medical, Dental, and Vision Insurance

403B Savings Plan w/employer contribution

Paid Time off & Paid holidays

Employee and Dependent Tuition assistance benefits

Health and wellness programs

Qualifications

• 3-5 years of experience in Contracting/Network Development within healthcare or insurance.
• Familiarity with reimbursement standards and managed care concepts.

Responsibilities

• Develop contractual relationships with behavioral health providers.
• Manage post-implementation processes of complex contracts.
• Audit and update pricing and reimbursement terms.

Skills

Negotiation

Analytical Skills

Communication

Education

Bachelor’s degree in business management

Bachelor’s degree in healthcare administration

Job description

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered and have a passion for being at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

• Work-life balance - This is a remote role. Applicants living in MD, VA, DC, PA, DE, or FL will be given first consideration. Quarterly travel to the Hanover, MD office may be required.
• Medical, Dental, and Vision Insurance.
• 403B Savings Plan w/employer contribution.
• Paid Time off & Paid holidays.
• Employee and Dependent Tuition assistance benefits.
• Health and wellness programs and MORE!

Who you are:

As a Contract Specialist II, your primary responsibilities will include developing provider networks through recruitment, negotiating complex contracts, and managing provider relationships. You will review network adequacy, identify recruitment needs, and negotiate within financial parameters to support JHHP’s strategic goals.

What you’ll do:

• Develop contractual relationships with behavioral health providers including psychiatrists, therapists, residential treatment facilities, and outpatient clinics.
• Lead the implementation of contracts, ensuring proper loading into provider systems, reporting, and operational readiness.
• Manage post-implementation processes of complex contracts, including behavioral health providers.
• Audit and update pricing and reimbursement terms to ensure compliance and appropriate reimbursement.
• Serve as the Networks management representative to address questions or concerns related to complex contracts.

What you’ll bring:

• 3-5 years of experience in Contracting/Network Development within healthcare or insurance settings, with familiarity in reimbursement standards.
• Strong negotiation skills, especially for high-dollar reimbursements, and knowledge of healthcare contracting terms.
• Ability to negotiate provider fee schedules and performance guarantees.
• Experience with alternative reimbursement standards and cost-efficient strategies.
• Knowledge of managed care concepts, MHPAEA, HIPAA, CMS guidelines, and Medicaid requirements.
• Analytical skills in claims, utilization, cost data, and market rates.
• Proficiency in data analysis for pricing and financial decision-making.
• Excellent communication skills.

Bachelor’s degree in business management or healthcare administration is required; experience with APMs, value-based contracting, and bundled payments is highly preferred. Skills in network adequacy analysis and strategic expansion are also preferred.

Who we are:

Johns Hopkins Health Plans (JHHP) is a managed care and health services business of Johns Hopkins Medicine, serving over 500,000 members across various lines of business. We are committed to transforming healthcare through innovative, analytics-driven programs in collaboration with provider partners.

Salary Range: $28.47/hour - $47.00/hour, commensurate with experience and role scope.

JHM prioritizes employee health and well-being. Join us and be part of a diverse and inclusive environment where everyone is valued and contributing to equitable healthcare delivery.

Johns Hopkins Health System and its affiliates are drug-free workplaces.