Remote Hospital Contracting Leader: Value-Based

CarePlus Health Plans; Tennessee; On-site; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Remote work option

Job summary

CarePlus Health Plans is seeking a Senior Hospital Contracting Strategist to initiate, negotiate, and execute provider contracts for a health insurance organization. This role reports to the Director, Provider Contracting and focuses on hospital and health system agreements, reimbursement methodologies, and value-based contracting.

The Senior Specialist will lead negotiations, analyze financial impact, and collaborate with cross-functional teams to ensure contracts are financially sound and

Qualifications

• Bachelor's degree required in a related field.
• 5+ years hospital negotiation experience in Medicare.
• 5+ years progressive network management experience including hospital contracting.
• Experience negotiating managed care contracts with hospital systems.
• Analyze and communicate financial impact of contract terms.
• Understand and interpret hospital contract language.
• Proficient in Microsoft Office: Word, Excel and PowerPoint.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement and renewals.
• Manage value-based and alternative payment arrangements.
• Collaborate with Finance, Legal, Network Management and Operations to ensure contracts are sound.
• Communicate contract terms and reimbursement rates to providers.
• Evaluate financial impact of contracts and terms.
• Maintain contracts and documentation in tracking systems.
• Recruit providers based on network needs.

Skills

Negotiation

Managed care

Medicare/Medicaid

Financial analysis

Provider contracting

Office software

Education

Bachelor's degree

Master's degree (preferred)

Tools

Microsoft Office

Job description

CarePlus Health Plans is seeking a Senior Hospital Contracting Strategist to initiate, negotiate, and execute provider contracts for a health insurance organization. This role reports to the Director, Provider Contracting and focuses on hospital and health system agreements, reimbursement methodologies, and value-based contracting.

The Senior Specialist will lead negotiations, analyze financial impact, and collaborate with cross-functional teams to ensure contracts are financially sound and