Contracting Specialist Senior

Johns Hopkins Medicine; Maryland; On-site; USD 47,000 - 78,000; Full time

Job summary

Johns Hopkins Medicine seeks a Contracts and Network Development professional to build and maintain a robust provider network, recruit new providers, and re-contract existing relationships while negotiating complex contracts to meet strategic goals and cost targets.

The role collaborates with analytics and finance to model value-based arrangements, implements contracts in maintenance systems, and oversees post-implementation performance to ensure high-quality outcomes across specialties.

Qualifications

• Minimum five years of contracting/network development in healthcare delivery or insurance.
• Experience with provider contracting and fee schedules.
• Knowledge of managed care concepts and billing information systems.
• Value Based/Gain Share/Risk contracting experience preferred.

Responsibilities

• Develop provider networks including recruitment and re-contracting.
• Review network adequacy and recruit to fill gaps to meet standards.
• Negotiate complex contracts within financial parameters.
• Lead contract loading into provider maintenance systems and post-implementation oversight.
• Audit pricing and reimbursement terms for compliance.

Skills

Provider contracting

Contract negotiation

Network development

Fee schedules

Education

Bachelor’s degree in business management or healthcare administration

Master’s degree preferred

Job description

Job Summary:

Responsible for maintaining a primary responsibility for the development of provider networks that includes recruitment, negotiating complex contracts, contacting, and re-contracting of current provider network. The position is responsible for reviewing network adequacy and determining recruitment needs within all specialties, taking appropriate actions to recruit new providers to fill in gaps to meet accreditation standards and JHHP’s strategic initiatives, and negotiating within the financial parameters to gain maximum cost efficiency and support JHHP’s goals and strategic initiatives.

Negotiates complex contracts including Value based Contracts, Cost Reduction Related Contracts, \"Risk\" agreements, etc. Works in conjunction with analytics and the Finance team to develop financial models analyzing Value Based Contracts shared savings, Capitation, bundled pricing, and other reimbursement methodologies. Negotiates complex managed care contracts securing optimal reimbursement and driving high Quality outcomes.

Leads the implementation process to ensure all contracts are loaded into the provider maintenance Systems, reporting is implemented and contract is operational. Manages the post implementation Process of all assigned Complex Contracts. Manages and audits the loading and updates of pricing and reimbursement terms to ensure contract compliance and appropriate reimbursement. Actively works within Networks Management and is the JHHP Networks management representative to address any questions or concerns related to complex contracts.

Qualifications:

Education:

Bachelor’s degree in business management or healthcare administration or related discipline required. Experience in lieu of education may be considered on a 2:1 basis. Master’s degree preferred.

Work Experience:

Requires a minimum of five (5) years of experience in Contracting/Network Development in healthcare delivery program or insurance setting, experience in developing various reimbursement standards. May provide guidance or expertise to less experienced specialists. Experience should include: provider contracting, negotiating complex fee schedules, knowledge of managed care concepts and billing information systems. Value Based/Gain Share/Risk contracting experience preferred for Contracting Specialist III.

Salary Range:

Minimum 34.41/hour - Maximum 56.82/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

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